Phasic intercostal muscle reduction during rapid eye movement sleep

Abstract

Introduction/Aim: The excitatory and inhibitory processes in rapid eye movement (REM) sleep are hypothesized to be associated with diseases like sudden infant death syndrome (SIDS). We aim to characterize a phenomenon of decreased respiratory muscle activity in association with rapid eye movements (REMs) during REM sleep and to generate further hypotheses for neurophysiological mechanisms of central respiratory control and its role in disease and health. Methods: REMs and clusters of REMs from polysomnography (PSG) of children with Down syndrome (DS) and neurotypical children (TD) between ages two and five years old were retrospectively reviewed. Thoracic respiratory inductance plethysmography band (tRIP) signals were evaluated preceding and following REMs and REMs clusters. REMs or REMs clusters associated with a reduction in tRIP amplitude or central apnoea were counted as positive (dREMs or dREMs cluster). tRIP signals with no change in amplitude or associated with movement artefact were counted negative. Events were independently scored by MDW and SS. Results: Five DS children vs. five TD children had a median increase in REMs (177 vs. 135), dREMs (86 vs. 59), REMs clusters (39 vs. 29), dREMs clusters (23 vs. 13) and REMs per minute of REM sleep (1.8 vs. 1.1). There were no significant differences in age, total sleep time, or sleep efficiency. Conclusion: Children with low tone syndromes will exhibit greater phasic inhibition of respiratory muscle activity due to a disorder of central respiratory control and regulation and inhibitory/excitatory processes in sleep. Similar phenomena could contribute to gas exchange abnormalities noted in children with central dysrhythmic breathing.L6269407782019-04-02 <br />