Arousal pattern following central and obstructive breathing abnormalities in infants and children. McNamara, Frances, Faiq G. Issa, Colin E. Sullivan. National SIDS Council David Read Paediatric Sleep Disorders Unit, Royal Alexandra Hospital for Children, Camperdown, and Department of Medicine, University of Sydney, Sydney, New South Wales, AUSTRALIA
APStracts 3:0457A, 1996.
We analyzed the polysomnographic records of 15 children and 20 infants with obstructive sleep apnea (OSA) to examine the interaction between central and obstructive breathing abnormalities and arousal from sleep. Each patient was matched for age with an infant or child who had no OSA. We found that the majority of respiratory events in infants and children were not terminated with arousal. In children, arousals terminated 39.3 +/- 7.2% of respiratory events during quiet sleep and 37.8 +/- 7.2% of events during active (REM) sleep. In infants, arousals terminated 7.9 +/- 1.0% of events during quiet and 7.9 +/- 1.2% of events during active sleep. In both infants and children, however, respiratory related arousals occurred more frequently following obstructive apneas and hypopneas than central events. Spontaneous arousals occurred in all patients with OSA during quiet and active sleep. The frequency of spontaneous arousals was not different between children with OSA and their matched controls. During active sleep, however, infants with OSA had significantly less spontaneous arousals than control infants. We conclude that arousal is not an important mechanism in the termination of respiratory events in infants and children and that EEG criteria are not essential to determine the clinical severity of OSA in the pediatric population. 

Received 21 February 1996; accepted in final form 1 October 1996.
APS Manuscript Number A171-6.
Article publication pending Journal of Applied Physiology.
ISSN 1080-4757 Copyright 1996 The American Physiological Society.
Published in APStracts on 5 November 1996