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Actigraphy and Behavioral State in Premature Infants Exposed to Methylxanthines

Actigraphy and Behavioral State in Premature Infants Exposed to Methylxanthines. Presented By Chris Sherman. Theophylline as a Treatment for Infant Sleep Apnea. Premature Infant Sleep Apnea. Treatment. Common in VLBW (Very Low Birth Rate) infants

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Actigraphy and Behavioral State in Premature Infants Exposed to Methylxanthines

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  1. Actigraphy and Behavioral State in Premature Infants Exposed to Methylxanthines Presented By Chris Sherman

  2. Theophylline as a Treatment for Infant Sleep Apnea Premature Infant Sleep Apnea Treatment • Common in VLBW (Very Low Birth Rate) infants • Episodic (each lasting more than fifteen seconds) • Symptoms include: Color/tonal change, loud breathing, limp musculature, heartrate <90bpm • Standard U.S. treatment: Caffeine (P.O.) or Theophylline (I.V. or P.O.) • Effectively bind more O2 while decreasing C02 levels; leads to improved respiratory functioning • Both bronchodilators produce autonomic side effects including tachycardia

  3. Hypothesized effects of Methylxanthines on Sleep State Regulation Sleep Onset Adenosine • Increased Adenosine build-up promotes sleep circadian cycling; binding of Adenosine promotes sleep • Methylxanthines bind to the Adenosine receptor sites, blocking out Adenosine Theophylline Result: Decreased Adenosine binding, increased Methylxanthine binding, decreased wakefulness A1 A1 A2a

  4. General Procedure Control Group: N= 11 Theophylline Group: N=14 Caffeine Group N=14 • Each infant was tested in the NICU of EMCC while in their home incubators • Actigraphy: Piezo-electric sensors were placed under clothing along infant’s spine. These recordings were performed in-sync with video equipment recording at 4 readings/frames per second • Data analyzed for overall motility during sleep; wake/sleep • Waking periods over 1.5 min in length qualified as a “waking state”

  5. Results/Discussion • Prior exposure to Methylxanthines was substantially longer in the Caffeine group Note: A maturational hypothesis was offered in the event results were caused by a difference in PCA (all subjects were between 28-38 weeks PCA) • Actigraphy results showed that Methylxanthine exposure predicted an increase in wakefulness, suggesting an altered temporal organization of motor activity • Exposure to Methylxanthines in a developing premature infant may negatively impact the sleep and arousal systems; this is associated with a greater risk of SIDS

  6. Note: All of the findings/data presented in this slideshow originated from the unpublished work (as of January 2006) of the University of Maine’s Developmental Neuroscience Lab. The presenter had no involvement with the original study.

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