Vasoconstriction following spontaneous sighs and head-up tilts in infants sleeping prone and supine

The cutaneous vasoconstrictor responses following a 60° head-up tilt and a spontaneous sigh were measured in 36 infants at 1 and 3 months age to investigate the effects of age, sleep state and sleep position on these responses. The vasoconstrictor response was determined by a measure of cutaneous blood flow using a laser Doppler flowmeter. The mean reduction in blood flow (vasoconstriction) was 52% following the tilt, and 33% following the sigh. Prone positioning 1-month-old infants as compared to supine, reduced the degree of vasoconstriction following the tilt ( P=0.027) and sigh ( P=0.026). The supine to prone reduction was: tilt, −11% in quiet sleep (QS) (from 55.1 to 49.1% vasoconstriction) and −18% in active sleep (AS) (from 52.0 to 42.9%) and; sigh, −26% in QS (35–26%), and −15% in AS (31–26%). The degree of vasoconstriction following the sigh was significantly greater in 3- compared to 1-month-old infants (+26%, P=0.040). The mean response to the tilt in the older age group was 12% greater but this did not reach significance ( P=0.069). Sleep state did not affect the degree of vasoconstriction but influenced transmission of the response so that latency to minimal vasoconstriction was 1 s shorter in AS than QS. This study provides data on two simple measures of sympathetic activity during sleep that have not previously been described in any detail in infant studies, and add more evidence that autonomic activity is reduced in the prone position compared to supine during sleep.