Respiratory EMG findings in relation to periodic breathing in infants

Abstract

Intercostal and diaphragm EMG activity was analysed in periodically breathing infants. The aim was to investigate relationships between changes in tonic activity in the respiratory muscles and switches in spontaneous breathing pattern from periodic to continuous and vice versa. A heterogeneous group of 13 normal and neurologically suspect infants was studied. They had all previously undergone polygraphic investigation and were selected because their polygraphic records showed at least three minutes uninterrupted periodic breathing (PB). PB appeared to represent an oscillation with a length of about 16 seconds superimposed on the basic state related irregular and regular breathing patterns. The development of a normal level of tonic activity in the respiratory muscles at the transition from state 2 to state 1 coincided with the switching from periodic to continuous breathing. Continuation of PB throughout a state 1 epoch in the presence of tonic respiratory muscle activity was exceptional. Sighs alone or sighs together with brief movements during state 1 were followed on occasion by a drop in tonic activity and a switch from continuous to periodic breathing. If the tonic activity rose again, PB either stopped or became less pronounced. TcPO 2 level measured in four infants rose when tonic activity rose and was lower during PB than during continuous breathing. The observations made in this study suggest that mechanical or chemical changes caused by changes in tonic activity level may affect the stability of respiratory control in infancy.