Delayed blood pressure recovery after head-up tilting during sleep in preterm infants

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Abstract

Dramatic changes in cardiovascular control occur in sleep during infancy, when sleep time is at a lifetime maximum. In infants born preterm there are significant cardiovascular complications later in life, and also an increased risk for sudden infant death syndrome (SIDS), possibly a result of inadequate compensation to a cardiorespiratory challenge in sleep. We aimed to examine the consequences of preterm birth on heart rate (HR) and blood pressure (BP) responses to head-up tilting (HUT) during sleep in infants. Preterm (n = 25) and term (n = 20) infants were studied using daytime polysomnography at 2-4 weeks , 2-3 months and 5-6 months term-corrected age (CA). BP was recorded using a photoplethysmographic cuff (Finometer); 15 degrees HUTs were performed during both quiet and active sleep. Preterm infants responded to HUT with increased HR and BP, followed by a bradycardia and a subsequent return of HR and BP to baseline. Overall, HUT responses were similar between term and preterm infants at matched ages. Notably, however, return of BP to baseline was considerably delayed in preterm infants ( approximately 37 beats post-tilt) compared with term infants ( approximately 23 beats post-tilt) at both 2-4 weeks and 2-3 months CA (P <0.05). Our study has demonstrated that preterm infants respond to a BP perturbation with changes in HR that match those of term infants. However, delayed recovery of BP during sleep in the preterm infant may be indicative of underlying deficits or immaturity in vascular function or control, which may contribute to their vulnerability to SIDS and cardiovascular complications later in life.
Original languageEnglish
Pages (from-to)93 - 102
Number of pages10
JournalJournal of Sleep Research
Volume19
Issue number1 Pt 1
DOIs
Publication statusPublished - 2010

Cite this

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title = "Delayed blood pressure recovery after head-up tilting during sleep in preterm infants",
abstract = "Dramatic changes in cardiovascular control occur in sleep during infancy, when sleep time is at a lifetime maximum. In infants born preterm there are significant cardiovascular complications later in life, and also an increased risk for sudden infant death syndrome (SIDS), possibly a result of inadequate compensation to a cardiorespiratory challenge in sleep. We aimed to examine the consequences of preterm birth on heart rate (HR) and blood pressure (BP) responses to head-up tilting (HUT) during sleep in infants. Preterm (n = 25) and term (n = 20) infants were studied using daytime polysomnography at 2-4 weeks , 2-3 months and 5-6 months term-corrected age (CA). BP was recorded using a photoplethysmographic cuff (Finometer); 15 degrees HUTs were performed during both quiet and active sleep. Preterm infants responded to HUT with increased HR and BP, followed by a bradycardia and a subsequent return of HR and BP to baseline. Overall, HUT responses were similar between term and preterm infants at matched ages. Notably, however, return of BP to baseline was considerably delayed in preterm infants ( approximately 37 beats post-tilt) compared with term infants ( approximately 23 beats post-tilt) at both 2-4 weeks and 2-3 months CA (P <0.05). Our study has demonstrated that preterm infants respond to a BP perturbation with changes in HR that match those of term infants. However, delayed recovery of BP during sleep in the preterm infant may be indicative of underlying deficits or immaturity in vascular function or control, which may contribute to their vulnerability to SIDS and cardiovascular complications later in life.",
author = "Smith, {Nicole Brie} and Stephanie Yiallourou and Walker, {Adrian Mark} and Horne, {Rosemary Sylvia Claire}",
year = "2010",
doi = "10.1111/j.1365-2869.2009.00793.x",
language = "English",
volume = "19",
pages = "93 -- 102",
journal = "Journal of Sleep Research, Supplement",
issn = "0962-1105",
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number = "1 Pt 1",

}

Delayed blood pressure recovery after head-up tilting during sleep in preterm infants. / Smith, Nicole Brie; Yiallourou, Stephanie; Walker, Adrian Mark; Horne, Rosemary Sylvia Claire.

In: Journal of Sleep Research, Vol. 19, No. 1 Pt 1, 2010, p. 93 - 102.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Delayed blood pressure recovery after head-up tilting during sleep in preterm infants

AU - Smith, Nicole Brie

AU - Yiallourou, Stephanie

AU - Walker, Adrian Mark

AU - Horne, Rosemary Sylvia Claire

PY - 2010

Y1 - 2010

N2 - Dramatic changes in cardiovascular control occur in sleep during infancy, when sleep time is at a lifetime maximum. In infants born preterm there are significant cardiovascular complications later in life, and also an increased risk for sudden infant death syndrome (SIDS), possibly a result of inadequate compensation to a cardiorespiratory challenge in sleep. We aimed to examine the consequences of preterm birth on heart rate (HR) and blood pressure (BP) responses to head-up tilting (HUT) during sleep in infants. Preterm (n = 25) and term (n = 20) infants were studied using daytime polysomnography at 2-4 weeks , 2-3 months and 5-6 months term-corrected age (CA). BP was recorded using a photoplethysmographic cuff (Finometer); 15 degrees HUTs were performed during both quiet and active sleep. Preterm infants responded to HUT with increased HR and BP, followed by a bradycardia and a subsequent return of HR and BP to baseline. Overall, HUT responses were similar between term and preterm infants at matched ages. Notably, however, return of BP to baseline was considerably delayed in preterm infants ( approximately 37 beats post-tilt) compared with term infants ( approximately 23 beats post-tilt) at both 2-4 weeks and 2-3 months CA (P <0.05). Our study has demonstrated that preterm infants respond to a BP perturbation with changes in HR that match those of term infants. However, delayed recovery of BP during sleep in the preterm infant may be indicative of underlying deficits or immaturity in vascular function or control, which may contribute to their vulnerability to SIDS and cardiovascular complications later in life.

AB - Dramatic changes in cardiovascular control occur in sleep during infancy, when sleep time is at a lifetime maximum. In infants born preterm there are significant cardiovascular complications later in life, and also an increased risk for sudden infant death syndrome (SIDS), possibly a result of inadequate compensation to a cardiorespiratory challenge in sleep. We aimed to examine the consequences of preterm birth on heart rate (HR) and blood pressure (BP) responses to head-up tilting (HUT) during sleep in infants. Preterm (n = 25) and term (n = 20) infants were studied using daytime polysomnography at 2-4 weeks , 2-3 months and 5-6 months term-corrected age (CA). BP was recorded using a photoplethysmographic cuff (Finometer); 15 degrees HUTs were performed during both quiet and active sleep. Preterm infants responded to HUT with increased HR and BP, followed by a bradycardia and a subsequent return of HR and BP to baseline. Overall, HUT responses were similar between term and preterm infants at matched ages. Notably, however, return of BP to baseline was considerably delayed in preterm infants ( approximately 37 beats post-tilt) compared with term infants ( approximately 23 beats post-tilt) at both 2-4 weeks and 2-3 months CA (P <0.05). Our study has demonstrated that preterm infants respond to a BP perturbation with changes in HR that match those of term infants. However, delayed recovery of BP during sleep in the preterm infant may be indicative of underlying deficits or immaturity in vascular function or control, which may contribute to their vulnerability to SIDS and cardiovascular complications later in life.

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M3 - Article

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JO - Journal of Sleep Research, Supplement

JF - Journal of Sleep Research, Supplement

SN - 0962-1105

IS - 1 Pt 1

ER -