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Effect of prone and supine position on sleep, apneas, and arousal in preterm infants

Effect of prone and supine position on sleep, apneas, and arousal in preterm infants
Effect of prone and supine position on sleep, apneas, and arousal in preterm infants
OBJECTIVE. Prematurely born compared with term born infants are at increased risk of sudden infant death syndrome, particularly if slept prone. The purpose of this work was to test the hypothesis that preterm infants with or without bronchopulmonary dysplasia being prepared for neonatal unit discharge would sleep longer and have less arousals and more central apneas in the prone position.
METHODS. This was a prospective observational study in a tertiary NICU. Twenty-four infants (14 with bronchopulmonary dysplasia) with a median gestational age of 27 weeks were studied at a median postconceptional age of 37 weeks. Video polysomnographic recordings of 2-channel electroencephalogram, 2-channel electro-oculogram, nasal airflow, chest and abdominal wall movements, limb movements, electrocardiogram, and oxygen saturation were made in the supine and prone positions, each position maintained for 3 hours. The duration of sleep, sleep efficiency (total sleep time/total recording time), and number and type of apneas, arousals, and awakenings were recorded.
RESULTS. Overall, in the prone position, infants slept longer, had greater sleep efficiency (89.5% vs 72.5%), and had more central apneas (median: 5.6 vs 2.2), but fewer obstructive apneas (0.5 vs 0.9). The infants had more awakenings (9.7 vs 3.5) and arousals per hour (13.6 vs 9.0) when supine. There were similar findings in the bronchopulmonary dysplasia infants.
CONCLUSIONS. Very prematurely born infants studied before neonatal unit discharge sleep more efficiently with fewer arousals and more central apneas in the prone position, emphasizing the importance of recommending supine sleeping after neonatal unit discharge for prematurely born infants.
apnea, arousal, sleeping position
0031-4005
101-107
Bhat, Ravindra Y.
ee315010-b399-4e25-b022-09da6f7d937b
Hannam, Simon
7bbc387c-e3b2-42db-aa76-278e92bf1772
Pressler, Ronit
bd9e312f-6a0e-4530-a2f0-a36b358db213
Rafferty, Gerrard F.
4ecc9b30-5f92-41d2-8598-b72029c00062
Peacock, Janet L.
1cb1242c-7606-4f8e-86d0-d3cd2ceff782
Greenough, Anne
5fb7521d-ae58-4a58-9a0b-deddcf1647c2
Bhat, Ravindra Y.
ee315010-b399-4e25-b022-09da6f7d937b
Hannam, Simon
7bbc387c-e3b2-42db-aa76-278e92bf1772
Pressler, Ronit
bd9e312f-6a0e-4530-a2f0-a36b358db213
Rafferty, Gerrard F.
4ecc9b30-5f92-41d2-8598-b72029c00062
Peacock, Janet L.
1cb1242c-7606-4f8e-86d0-d3cd2ceff782
Greenough, Anne
5fb7521d-ae58-4a58-9a0b-deddcf1647c2

Bhat, Ravindra Y., Hannam, Simon, Pressler, Ronit, Rafferty, Gerrard F., Peacock, Janet L. and Greenough, Anne (2006) Effect of prone and supine position on sleep, apneas, and arousal in preterm infants. Pediatrics, 118 (1), 101-107. (doi:10.1542/peds.2005-1873).

Record type: Article

Abstract

OBJECTIVE. Prematurely born compared with term born infants are at increased risk of sudden infant death syndrome, particularly if slept prone. The purpose of this work was to test the hypothesis that preterm infants with or without bronchopulmonary dysplasia being prepared for neonatal unit discharge would sleep longer and have less arousals and more central apneas in the prone position.
METHODS. This was a prospective observational study in a tertiary NICU. Twenty-four infants (14 with bronchopulmonary dysplasia) with a median gestational age of 27 weeks were studied at a median postconceptional age of 37 weeks. Video polysomnographic recordings of 2-channel electroencephalogram, 2-channel electro-oculogram, nasal airflow, chest and abdominal wall movements, limb movements, electrocardiogram, and oxygen saturation were made in the supine and prone positions, each position maintained for 3 hours. The duration of sleep, sleep efficiency (total sleep time/total recording time), and number and type of apneas, arousals, and awakenings were recorded.
RESULTS. Overall, in the prone position, infants slept longer, had greater sleep efficiency (89.5% vs 72.5%), and had more central apneas (median: 5.6 vs 2.2), but fewer obstructive apneas (0.5 vs 0.9). The infants had more awakenings (9.7 vs 3.5) and arousals per hour (13.6 vs 9.0) when supine. There were similar findings in the bronchopulmonary dysplasia infants.
CONCLUSIONS. Very prematurely born infants studied before neonatal unit discharge sleep more efficiently with fewer arousals and more central apneas in the prone position, emphasizing the importance of recommending supine sleeping after neonatal unit discharge for prematurely born infants.

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More information

Published date: 1 July 2006
Keywords: apnea, arousal, sleeping position

Identifiers

Local EPrints ID: 61662
URI: http://eprints.soton.ac.uk/id/eprint/61662
ISSN: 0031-4005
PURE UUID: 26198dbc-7da7-4aaa-93a7-74948da9dc38

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Date deposited: 08 Sep 2008
Last modified: 13 Mar 2019 20:28

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Contributors

Author: Ravindra Y. Bhat
Author: Simon Hannam
Author: Ronit Pressler
Author: Gerrard F. Rafferty
Author: Janet L. Peacock
Author: Anne Greenough

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