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. 2014 Apr;29(4):530-3.
doi: 10.1177/0883073812470972. Epub 2013 Jan 9.

Sleep-wake cycling and cerebral oxygen metabolism among critically ill neonates

Renée A Shellhaas  1 , Joseph W Burns, Stephanie A Wiggins, Mary K Christensen, John D E Barks, Ronald D Chervin
Affiliations

Sleep-wake cycling and cerebral oxygen metabolism among critically ill neonates

Renée A Shellhaas et al. J Child Neurol. 2014 Apr.

Abstract

Among adults, wakefulness and rapid eye movement (REM) sleep, compared to non-REM sleep, require higher overall brain metabolism, but in neonates analogous data are not available. Behavioral states with higher metabolic demand could increase vulnerability to hypoperfusion or hypoxia in the compromised neonatal brain. Using cerebral oximetry (near-infrared spectroscopy), and simultaneous polysomnography, we evaluated whether brain oxygen metabolism varies by sleep-wake state among critically ill newborns. For each of 10 infants, sleep-wake cycling was detectable and cerebral oximetry varied (P < .0001) across behavioral states, but the patterns differed among subjects. We conclude that cerebral oxygen metabolism varies with sleep-wake states in high-risk newborns. The direction and degree of these changes are variable and subject-specific in this initial sample, but could reflect or affect brain injury and vulnerability.

Keywords: REM; near-infrared spectroscopy; neonatal; polysomnography; rapid eye movement; regional oxygenation; sleep.

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Conflict of interest statement

Conflicts of Interest: Somanetics, Inc (Troy, MI) donated NIRS equipment for research conducted in our neonatal intensive care unit, but had no input into this study’s design, data analysis, or writing of the manuscript.

Figures

Figure 1
Figure 1
Sample plots of fractional tissue oxygen extraction (FTOE) across sleep-wake states from an infant with seizures of uncertain etiology (panel A) and cerebral rSO2 values from an infant with hypoxic ischemic encephalopathy (panel B). Boxplots demonstrate the median, 25th, 75th, 10th, and 90th percentiles, with outliers. For each subject, there were statistically significant differences among sleep-wake states (p<0.0001).
See this image and copyright information in PMC

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