Hering-Breuer reflex and sleep state in the preterm infant

The aim of this study was to determine the effect of sleep state on the Hering‐Breuer inflation reflex in the preterm infant. Seventeen nonintubated, premature infants, ranging in birth weight from 980–2,440 g with postconceptual ages of 30–36 weeks, were studied. In each infant, pulmonary function...

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Bibliographic Details
Published in:Pediatric pulmonology 2004-01, Vol.37 (1), p.61-64
Main Authors: Hand, Ivan L., Noble, Lawrence, Wilks, Michelle, Towler, Edith, Kim, MaeHee, Yoon, Jing J.
Format: Article
Language:English
Subjects:
apnea
Biological and medical sciences
Female
General aspects
Hering-Breuer inflation reflex
Humans
Infant, Newborn
Infant, Premature - physiology
Male
Medical sciences
neonatology
Pneumology
pulmonary reflex
Reflex - physiology
Respiration
Sleep Stages - physiology
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Summary:The aim of this study was to determine the effect of sleep state on the Hering‐Breuer inflation reflex in the preterm infant. Seventeen nonintubated, premature infants, ranging in birth weight from 980–2,440 g with postconceptual ages of 30–36 weeks, were studied. In each infant, pulmonary function testing, including the Hering‐Breuer inflation reflex, was obtained using the SensorMedics 2600 during active and quiet sleep states in supine position. The strength of the Hering‐Breuer inflation reflex was quantified by the measurement of the percent prolongation of expiration after an occluded breath. Sleep states were categorized by the criteria of Prechtl. There was a significant difference in Hering‐Breuer activity in active (REM) vs. quiet (non‐REM) sleep, with a consistently stronger reflex in the active sleep state. The mean percent prolongation of expiration was 419% in active sleep vs. 87% in quiet sleep. Analysis of the data, using a paired t‐test, revealed a mean difference of 331 ± 185% between active and quiet sleep (P = 0.000). In conclusion, significant differences in the strength of the Hering‐Breuer inflation reflex occur in relation to sleep state, and may explain the variability of the reflex described in previous studies. Measurement of the Hering‐Breuer inflation reflex may be affected by pulmonary stretch receptors as well as chest wall afferents in the preterm infant. Pediatr Pulmonol. 2004; 37:61–64. © 2004 Wiley‐Liss, Inc.
ISSN:8755-6863
1099-0496
DOI:10.1002/ppul.10394