Central respiratory pauses, sighs, and gross body movements during sleep in children

Sighs (SIs) and gross body movements (GMs) during sleep are common spontaneous, arousal behaviors during sleep. These physiological behaviors either precede or follow central respiratory pauses (CPs) during sleep in normal subjects. However, little attention has been paid to the temporal relationships between CPs and spontaneous behaviors except in early infancy. In the present study, the age- and state-related changes in the frequency and duration of apnea–behavior relationships were studied cross-sectionally in 19 healthy children aged between 3 months and 7 years of age. CPs, SIs, and GMs were assessed in a single all-night polysomnography and respiratory inductive plethysmography. We divided the data into two age groups: less and more than 15 months of age. The results showed that frequency of CPs ≥10 s increased with age, while the frequency of GMs and SIs decreased. Isolated CPs appeared more frequently during rapid-eye-movement sleep (REMS) than during nonrapid-eye-movement sleep (NREMS). The frequency of both SIs and GMs that appeared after CPs was higher during REMS than during NREMS. The sum of CPs preceded by SI, and CPs preceded by GM accounted for about 75% of all central apnea events. These two events appeared more frequently during NREMS than during REMS and the duration of both events in NREMS increased significantly with age. During NREMS, few and delayed behaviors thought to restart respiration after CPs have been described. Future work should examine developmental differences in the occurrence of physiological behaviors in relation to CP in NREMS and REMS.