Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter January 30, 2013

Basic values for heart and respiratory rates during different sleep stages in healthy infants

  • Konrad Heimann EMAIL logo , Nicole Heussen , Peter Vaeßen , Cathrin Wallmeier , Thorsten Orlikowsky and Tobias G. Wenzl

Abstract

The aim of this study was to systematically register data for respiratory and heart rates (RR and HR, respectively) during different sleep stages [active (AS, i.e., rapid eye movement) and quiet (QS, i.e., non-rapid eye movement) sleep] and age in a large number of healthy infants (277) during the first year of life to simplify polysomnography. The reference values in this age group differ significantly between the number of patients and age at time of investigation. According to strict inclusion and exclusion criteria, the measurement of polysomnography included HR (beats per minute, or bpm), RR (breaths per minute, or breaths/min), brain waves, SO2, sound, and video. Data recording and evaluation occurred via Alice 3®/3.5®(Respironics®), classification into AS and QS sleep according to maturity. For RR, the 5th–95th percentiles during AS decreased from 25.8–47.7 breaths/min (1st month) to 17.8–27.7 breaths/min (>9 months). During QS, RR ranged from 27.4–51.5 breaths/min (1st month) to 17.8–29.2 breaths/min (>9 months). HR decreased during AS from 118.3–150.6 bpm (1st month) to 100.9–126.4 bpm (>9 months). During QS, HR decreased from 116.0–149.9 bpm (1st month) to 93.7–119.8 bpm (>9 months). The mean HR and RR significantly decreased with age in both sleep stages (p<0.05). The mean HR is significantly lower during QS compared with AS (p<0.05). Our data may serve as basic values for HR and RR in different sleep stages during the first year of life.


Corresponding author: Konrad Heimann, MD, PhD, University Children’s Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany, Phone: +49-241-8089380, Fax: +49-241-8082435

References

[1] American Thoracic Society. Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 1996; 153: 866–878.10.1164/ajrccm.153.2.8564147Search in Google Scholar

[2] Anders T, Emde R, Parmelle A. A manual of standardized terminology, techniques and criteria for scoring states of sleep and wakefulness in newborn infants. Los Angeles, CA: UCLA Brain Information Service/BRI 1971.Search in Google Scholar

[3] Aserinsky E, Kleitman N. A motility cycle in sleeping infants as manifested by ocular and gross bodily activity. J Appl Physiol 1955; 8: 11–13.10.1152/jappl.1955.8.1.11Search in Google Scholar

[4] Aurora RN, Zak RS, Karippot A, et al. Practice parameters for the respiratory indications for polysomnography in children. Sleep 2011; 34: 379–388.10.1093/sleep/34.3.379Search in Google Scholar

[5] Bloch KE. Polysomnography: a systematic review. Technol Health Care 1997; 5: 285–305.10.3233/THC-1997-5403Search in Google Scholar

[6] Clarenbach P, Klotz U, Koella WP, Rudolf GAE. Schering Lexikon Schafmedizin. München: MMV 1998.Search in Google Scholar

[7] Curzi-Dascalova L, Gaudebaout C, Dreyfus-Brisac C. Respiratory frequencies of sleeping infants during the first month of life: correlations between values in different sleep stages. Early Hum Dev 1981; 5: 39–54.10.1016/0378-3782(81)90069-4Search in Google Scholar

[8] Dement W, Kleitman N. Cyclic variations in EEG during sleep and their relation to eye movements, body motility, and dreaming. Electroencephalogr Clin Neurophysiol Suppl 1957; 9: 673–690.10.1016/0013-4694(57)90088-3Search in Google Scholar

[9] Duchna HW, Schaefer D, Wiemann J. Schlaflabor-Diagnostik. In: Rasche K, Konermann M, Schaefer T, Schlaefke ME, Strum A, Schultze-Werninghaus G, editors. Schlafbezogene Atmungsstörungen im Kindes- und Erwachsenenalter. München: MMV 1994: 69–75.Search in Google Scholar

[10] Erler T, Oehlschläger J, Nowotny T, Oppermann J. Polysomnographie im Säuglingsalter – notwendig oder teurer Luxus? Klin Padiatr 2001; 213: 114–121.10.1055/s-2001-15861Search in Google Scholar

[11] Erler T, Wischniewsky E. Sleep medicine in infants – practicability and limitations. Early Hum Dev 2001; 63: 23–35.10.1016/S0378-3782(01)00142-6Search in Google Scholar

[12] Fagioli I, Peirano P, Salzarulo P. Heart rate and sleep states in infants. Neurophysiol Clin 1994; 94: 24–50.10.1016/S0987-7053(05)80404-6Search in Google Scholar

[13] Gregory AM, Cousins JC, Forbes EE, et al. Sleep items in the child behavior checklist: a comparison with sleep diaries, actigraphy and polysomnography. J Am Acad Child Adolesc Psychiatry 2011; 50: 499–507.10.1016/j.jaac.2011.02.003Search in Google Scholar PubMed PubMed Central

[14] Grigg-Damberger M, Gozal D, Marcus CL, et al. The visual scoring of sleep and arousal in infants and children. J Clin Sleep Med 2007; 15: 201–240.10.5664/jcsm.26819Search in Google Scholar

[15] Harper RM, Hoppenbrouwers T, Sterman MB, McGinty DJ, Hodgman J. Polygraphic studies of normal infants during the first six months of life. I. Heart rate and variability as a function of state. Pediatr Res 1976; 10: 945–948.10.1203/00006450-197611000-00008Search in Google Scholar

[16] Hodgman JE, Cabal LA. Cardiorespiratory monitoring in the high-risk infant. Acute Care 1986; 12: 165–194.Search in Google Scholar

[17] Hoppenbrouwers T, Harper RM, Hodgman JE, Sterman MB, McGinty TJ. Polygraphic studies of normal infants during the first six months of life. II. Respiratory rate and variability as a function of state. Pediatr Res 1978; 12: 120–125.10.1203/00006450-197802000-00011Search in Google Scholar

[18] Horemuzova E, Katz-Salamon M, Milerad J. Breathing patterns, oxygen and carbon dioxide levels in sleeping healthy infants during the first nine months after birth. Acta Paediatr 2000; 89: 1284–1289.10.1111/j.1651-2227.2000.tb00752.xSearch in Google Scholar

[19] Litscher G, Pfurtscheller G, Bes F, Poiseau E. Respiration and heart rate variation in normal infants during quiet sleep in the first year of life. Klin Padiatr 1993; 205: 170–175.10.1055/s-2007-1025222Search in Google Scholar

[20] Lund R, Clarenbach P. Das klinische Schlaflabor. München: Arcis Verlag 1994.Search in Google Scholar

[21] Massin MM, Withofs N, Maeyns K, Ravet F, Gérard P. Normal ranges for the variability in heart rate in young infants while sleeping. Cardiol Young 2001; 11: 619–625.10.1017/S104795110100097XSearch in Google Scholar

[22] Niewerth HJ, Wiater A. Polysomnographische Untersuchungen für Säuglinge und Kinder – Anleitung für die Laborarbeit. Somnologie 2000; 4: 43–52.10.1046/j.1439-054x.2000.00115.xSearch in Google Scholar

[23] Nogues B, Vecchierini-Blineua MF, Louvet S, Desfonteaines O. Heart rate changes during sleep in normal two-month-old infants. Neurophysiol Clin 1996; 26: 414–422.10.1016/S0987-7053(97)89154-XSearch in Google Scholar

[24] Otto K, Mrowka R, Schubert E, Orlow W, Wauer RR, Patzak A. Low-frequency respiratory rhythms in infants during the first six months of life. Clin Physiol 2000; 20: 200–211.10.1046/j.1365-2281.2000.00247.xSearch in Google Scholar PubMed

[25] Rechtschaffen A, Kahles A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. National Institute of Health Publication No. 204. Washington, DC: US Government Printing Office 1968.Search in Google Scholar

[26] Theorell K, Prechtl HF, Vos JE. A polygraphic study of normal and abnormal newborn infants. Neuropädiatrie 1974; 5: 279–314.10.1055/s-0028-1091710Search in Google Scholar PubMed

[27] Scholle S, Wiater A, Scholle HC. Normative values of polysomnographic parameters in childhood and adolescence: cardiorespiratory parameters. Sleep Med 2011; 12: 988–996.10.1016/j.sleep.2011.05.006Search in Google Scholar PubMed

[28] Villa MP, Calcagnini G, Pagani J, Paggi B, Massa F, Ronchetti R. Effects of sleep stage and age on short-term heart variability during sleep in healthy infants and children. Chest 2000; 117: 460–466.10.1378/chest.117.2.460Search in Google Scholar PubMed

[29] Wagner I. Curves of sleep depth in newborn infants. J Genet Psycho 1939; 55: 121–135.10.1080/08856559.1939.10533187Search in Google Scholar

[30] Ward TM, Lentz M, Kieckhefer GM, Landis CA. Polysomnography and actigraphy concordance in juvenile idiopathic arthritis, asthma and healthy children. J Sleep Res 2012; 21: 113–121.10.1111/j.1365-2869.2011.00923.xSearch in Google Scholar PubMed PubMed Central

[31] Yiallourou SR, Walker AM, Horne RSC. Effects of sleeping position on development of infant cardiovascular control. Arch Dis Child 2008; 93: 868–872.10.1136/adc.2007.132860Search in Google Scholar PubMed

Received: 2012-4-4
Accepted: 2013-1-2
Published Online: 2013-01-30
Published in Print: 2013-02-01

©2013 by Walter de Gruyter Berlin Boston

Downloaded on 29.5.2024 from https://www.degruyter.com/document/doi/10.1515/bmt-2012-0013/html
Scroll to top button