Sleep position, autonomic function, and arousal
a Department of Paediatrics and Child Health, Otago
Medical School, POB 913, Dunedin, New Zealand, b Department of Physiology
Correspondence to: Dr Barbara Galland. E mail: bcgalland{at}gandalf.otago.ac.nz
Accepted 12
November 1997
AIMS
To investigate and compare heart rate
variability (HRV) and responses of heart rate and arousal to head-up
tilting in infants sleeping prone and supine.
METHODS
Thirty seven healthy infants aged
2-4 months were studied. HRV was measured for 500 beats while they
were in a horizontal position. Subjects were then tilted 60° head-up,
and heart rate recorded over 1 minute and arousal responses observed.
Data were collected during both quiet and active sleep for both prone
and supine sleep positions.
RESULTS
HRV, as assessed by the point
dispersion of Poincaré plots, was significantly reduced in the prone
position for both sleep states. Sleep position did not influence the
changes in heart rate seen during a head-up tilt. Full awakening to the
tilt was common in active sleep but significantly less so in the prone position (15% of prone tests vs 54% supine). Full
awakening to the tilt rarely occurred during quiet sleep in either
sleep position.
CONCLUSION
This study provides some
evidence that blunted arousal responses and/or altered autonomic
function are a feature of the prone sleeping position. Decreased HRV
may be a sign of autonomic impairment. It is seen in many disease
states and in infants who later die of sudden infant death syndrome (SIDS).
© 1998 by Archives of Disease in Childhood
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