Rapid Eye Movement Sleep, Apnea, and Cardiac Slowing Influenced by Phenobarbital Administration in the Neonate

Abstract

Polygraphic recordings were performed in 7 preterm infants who had been given phenobarbital (phenobarbitone) to evaluate its effect on neonatal sleep behavior and on the incidence of neurogenic apnea and/or bradycardia. The amount of active sleep, as well as the incidence of apnea and/or cardiac slowing occurring predominantly in active sleep, were decreased at therapeutic serum levels of phenobarbital. With declining serum drug levels, active sleep showed a rebound effect; at the same time, apnea and/or cardiac slowing relapsed. The neurophysiologic concept that neonatal apnea is facilitated by active sleep-inhibitory brain mechanisms seem to be confirmed.