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1 Department of Child Health, Leicester University, Leicester LE2 7LX, United Kingdom; 2 Department of Physics, University of Notre Dame, South Bend, Indiana 46556; and 3 Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
Unlike older
children, young infants are prone to develop unstable respiratory
patterns, suggesting important differences in their control of
breathing. We examined the irregular breathing pattern in infants by
measuring the time interval between breaths ("interbreath
interval"; IBI) assessed from abdominal movement during 2 h of sleep
in 25 preterm infants at a postconceptional age of 40.5 ± 5.2 (SD) wk and in 14 term healthy infants at a postnatal age of 8.2 ± 4 wk. In 10 infants we performed longitudinal measurements on two
occasions. We developed a threshold algorithm for the detection of a
breath so that an IBI included an apneic period and potentially some
periods of insufficient tidal breathing excursions (hypopneas). The
probability density distribution (P) of IBIs follows a power law,
P(IBI)~IBI
,
with the exponent 
providing a statistical measurement of the relative risk of insufficient breathing. With maturation, increased from 2.62 ± 0.4 at 41.2 ± 3.6 wk to 3.22 ± 0.4 at
47.3 ± 6.4 wk postconceptional age, indicating a decrease in long
hypopneas (for paired data P = 0.002). The statistical
properties of IBI were well reproduced in a model of the respiratory
oscillator on the basis of two hypotheses:
1) tonic neural inputs to the respiratory oscillator are noisy; and
2) the noise explores a critical
region where IBI diverges with decreasing tonic inputs. Accordingly,
maturation of infant respiratory control can be explained by the tonic
inputs moving away from this critical region. We conclude that
breathing irregularities in infants can be characterized by , which
provides a link between clinically accessible data and the
neurophysiology of the respiratory oscillator.
control of breathing; apnea; hypopnea; neural network
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