Apnoea suppresses brain activity in infants

Abstract

Apnoea - the cessation of breathing - is commonly observed in premature infants. These events can reduce cerebral oxygenation and are associated with poorer neurodevelopmental outcomes. However, relatively little is known about how apnoea and shorter pauses in breathing impact brain function in infants, which will provide greater mechanistic understanding of how apnoea affects brain development. We analysed simultaneous recordings of respiration, electroencephalography (EEG), heart rate, and peripheral oxygen saturation in 124 recordings from 118 infants (post-menstrual age: 38.6 {+/-} 2.7 weeks [mean {+/-} standard deviation]) during apnoeas (pauses in breathing greater than 15 seconds) and shorter pauses in breathing between 5 and 15 seconds. EEG amplitude significantly decreased during both apnoeas and shorter pauses in breathing compared with normal breathing periods. Change in EEG amplitude was significantly associated with change in heart rate during apnoea and breathing pauses and, during apnoeas only, with oxygen saturation change. No associations were found between EEG amplitude and pause duration or post-menstrual age. The decrease in EEG amplitude may be a result of the changing metabolism and/or homeostasis following changes in oxygen and carbon dioxide concentrations, which alters the release of neurotransmitters. As apnoeas often occur in premature infants, frequent disruption to brain activity may impact neural development and result in long-term neurodevelopmental consequences.