PEDIATRICS Vol. 97 No. 2 February 1996, pp. 174-178
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Decreased Cardiac Responses to Auditory Stimulation During Prone Sleep

Patricia Franco MD1, Jose Groswasser MD2, Martine Sottiaux DP2, Ema Broadfield MD2, and A. Kahn MD, PhD2

1 The Pediatric Sleep Unit, Erasme University Clinics, Belgium.
2 The Pediatric Sleep Unit, Erasme University Clinics, and University Children's Hospital of Brussels, Belgium.

Objective. To evaluate the relationship between body position during sleep and the infants' cardiac responses to auditory stimulation.

Methods. Thirty healthy infants with a median age of 11 weeks were studied polygraphically for one night, while sleeping successively prone and supine, or vice versa. Their behavioral and cardiac responses were recorded during rapid eye movement (REM) sleep, both before and after exposure to 90 dB (A) of white-noise.

Results. Ten infants were excluded from the study, because they woke up during the challenge. For the 20 infants included in the analysis, no significant difference was seen between the prone and the supine position for total sleep time, sleep efficiency, percent of REM and nonrapid eye movement sleep, number of gross body movements, transcutaneous oxygen saturation levels, mean cardiac rate, heart rate variability, number of heart rate drops; mean respiratory rate, and number or duration of central or obstructive apneas. Auditory challenges induced significantly less overall changes in heart rate, less heart rate drops, less heart rate variability, as well as fewer and shorter central apneas in the prone than in the supine position. Autoregressive power spectral analysis of the heart rate was consistent with a possible increase in orthosympathetic tone in the prone position.

Conclusion. Prone sleeping was associated with a decrease in cardiac responses to auditory stimulation and a possible increase in orthosympathetic activity. Prone positioning could favor a reduced reactivity to danger-signaling stimuli during REM sleep.

Key Words: sleep • body position • auditory stimulation • stress • sudden infant death syndrome • autonomic control

Submitted on October 28, 1994
Accepted on March 17, 1995




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