Miano Silvia, Peraita-Adrados Rosa, Montesano Marilisa, Castaldo Rosa, Forlani Martina, Villa Maria Pia
Department of Pediatrics, Sleep Disorder Centre, University of Rome La Sapienza-Sant'Andrea Hospital, Rome, Italy.
Brain Dev. 2011 May;33(5):421-7. doi: 10.1016/j.braindev.2010.07.008. Epub 2010 Aug 19.
We evaluated the cyclic alternating pattern (CAP) during the first year of life in order to obtain information on the maturation of arousal mechanisms during NREM sleep and to provide normative data for CAP parameters in this age range (5-16months). Eleven healthy children (mean age 7.9±3.3months, seven boys) were studied while they slept in the morning. They underwent a 3-h video-EEG-polysomnographic recording at the Pediatric Sleep Unit of Sant'Andrea Hospital in Rome, Italy. Sleep was scored visually for sleep architecture and CAP analysis using standard criteria. Our results were complemented by CAP data from a previous sample of healthy infants (2-4months), studied when they slept during the morning, in order to correlate CAP parameters with age. The total sample comprised 24 children. The sleep period was approximately 2h, with a first REM latency of about 30min, and a clear distinction between stages N1, N2, and N3. The arousal index was 12±2.1 events/hour of sleep. The total CAP rate was 23.7±7.6%, and it increased progressively with the deepness of sleep; the highest values were observed during stage N3 and the lowest values during stage N1. A1 phases were the most numerous (78.2%), followed by A2 (14%) and A3 (7.7%) phases. The A1 index was higher than the A2 and A3 indices, whereas the mean duration of B was higher than that of A. The correlation showed that the CAP rate, A1, A2, A3 indices, A2, A3 percentages, and the average duration of B increased with age, whereas the A1 percentage decreased. We provide the first data on CAP analysis in children aged 5-16months, studied when they slept during the morning. Our results confirm the trend toward an increase in CAP rate during the first year of life. In addition, we observed a progressive increase in CAP rate with deepness of sleep, and with age, reflecting maturation of slow-wave activity. The decreased percentage of A1 subtypes may reflect the maturation of arousability.
我们评估了1岁以内儿童的周期性交替模式（CAP），以获取有关非快速眼动睡眠期间觉醒机制成熟度的信息，并提供该年龄范围（5 - 16个月）内CAP参数的规范数据。对11名健康儿童（平均年龄7.9±3.3个月，7名男孩）进行了早晨睡眠时的研究。他们在意大利罗马圣安德烈亚医院的儿科睡眠单元接受了3小时的视频脑电图 - 多导睡眠图记录。使用标准标准对睡眠结构和CAP分析进行视觉评分。我们的结果通过之前一组健康婴儿（2 - 4个月）早晨睡眠时的CAP数据得到补充，以便将CAP参数与年龄相关联。总样本包括24名儿童。睡眠时间约为2小时，首次快速眼动潜伏期约为30分钟，N1、N2和N3期之间有明显区别。觉醒指数为每小时睡眠12±2.1次事件。总CAP率为23.7±7.6%，并且随着睡眠深度的增加而逐渐升高；在N3期观察到最高值，在N1期观察到最低值。A1期最多（78.2%），其次是A2期（14%）和A3期（7.7%）。A1指数高于A2和A3指数，而B期的平均持续时间高于A期。相关性表明，CAP率、A1、A2、A3指数、A2、A3百分比以及B期的平均持续时间随年龄增加，而A1百分比下降。我们提供了5 - 16个月儿童早晨睡眠时CAP分析的首批数据。我们的结果证实了生命第一年中CAP率增加的趋势。此外，我们观察到CAP率随着睡眠深度和年龄的增加而逐渐升高，反映了慢波活动的成熟。A1亚型百分比的下降可能反映了唤醒能力的成熟。
