[Indications of electroencephalogram in the newborn].

The electroencephalogram (EEG), an easy-to-use and non invasive cerebral investigation, is a useful tool for diagnosis and early prognosis in newborn babies. In newborn full term babies manifesting abnormal clinical signs, EEG can point focal lesions or specific aetiology. EEG background activity and sleep organization have a high prognostic value.

Ambulatory sleep recording in a healthcare network: a feasibility study.

Sleep disorders have a high prevalence: around 20% of insomniacs, 10% hypersomnolent including 2 to 4% of sleep disordered breathing in the general adult population. The low availability of sleep centres implies the research of alternative recording techniques in the natural setting of the patient. The objective was to evaluate an ambulatory recorder and its integration in a managed healthcare network.

Autonomic control of the cardiovascular system during sleep in normal subjects.

The autonomic control of heart rate and blood pressure during sleep is controversial: although it has been reported that vagal activity is more often lower in rapid eye movement sleep (REM) than in other stages of sleep (non-REM, NREM), the opposite has also been described. Initially, it was reported that baroreflex sensitivity (BRS) increases during sleep (REM and NREM), but in later studies, this was only partially confirmed. We therefore studied autonomic control of the cardiovascular (CV) system during sleep in 12 normal adults.

[Obstructive sleep apnea syndrome and heart failure].

Heart failure has an increasing prevalence in middle age adults. The prognosis is very poor even with improved medical therapy and heart transplants. The outcome is related to the neurohumoral disease resulting from heart failure which leads to sympathetic activation that in turns worsens the prognosis.

Needs and costs of sleep monitoring.

Sleep disorders have a high prevalence in the general population: insomnia (10-20% of adults), sleep apnoea syndromes (4-6%). They are responsible for high costs of investigations and treatment modalities. The investigations are usually done in sleep laboratories at the expense of cost in personnel and long waiting lists.

[Heart failure and sleep respiratory disorders. Prevalence, physiopathology and treatment].

Cheyne-Stokes respiration occurs during sleep in 40-45% of patients with NYHA class III and IV heart failure. Such patients experience repeated episodes of progressively diminishing ventilation associated with desaturation followed by periods of increasing-amplitude ventilation. The mechanism appears to be related to hyperventilation leading to hypocapnia which occurs near a critical threshold of apnea during sleep stages I and stage II and interrupts central ventilatory control.

[Sleep-related cardiac insufficiency and respiratory disorders. Prevalence, physiopathology, and treatment].

Cheyne-Stokes respiration occurs during sleep in 40-45% of patients with NYHA class III and IV heart failure. Such patients experience repeated episodes of progressively diminishing ventilation associated with desaturation followed by periods of increasing-amplitude ventilation. The mechanism appears to be related to hyperventilation leading to hypocapnia which occurs near a critical threshold of apnea during sleep stages I and stage II and interrupts central ventilatory control.

[[Emergency pediatric EEG in mental confusion, behavioral disorders and vigilance disorders: a retrospective study].

Recording of electroencephalogram (EEG) is of value to estimate vigilance states in children as in adults. In order to determine the diagnostic and prognostic value of emergency EEG in case of mental confusion, behavioral disorders and vigilance disorders in childhood, we conducted a retrospective study in 397 children (aged 2 months to 16 years). EEG was recorded less than 24 hours after an emergency consultation for acute confusion or acute behavioral disorder (n = 106) or after admission to the intensive care unit for comatose stage (n = 291).

The early diagnosis of periventricular leukomalacia in premature infants with positive rolandic sharp waves on serial electroencephalography.

Objective: The objective of this study was to determine the specificity and the sensitivity of electroencephalography's positive rolandic sharp waves (PRSW) for the diagnosis of cystic and noncystic periventricular leukomalacia (PVL).

Methods: A retrospective study was performed on a population of 765 premature infants alive after 5 days who were divided into two groups; 166 infants born before 28 weeks (group 1) and 599 born between 28 and 32 completed weeks' gestation (group 2). Each infants underwent repeated ultrasound scanning and electroencephalography recordings during the first weeks of life.

[Intraventricular hemorrhage and parenchymatous ischemia in the newborn at term. Report of five cases].

Although intraventricular hemorrhage associated with cerebral ischemia without severe perinatal asphyxia is rare in full-term newborns, it can be severe, have early or late onset depending on the etiology and be of poor prognosis. Five full-term neonates (37 to 41 weeks of gestational age) without criteria of severe perinatal asphyxia were admitted to the intensive care unit for seizures: four were between seven and 11 days of age and one was only 12 h old. Clinical or electroclinical seizures recorded by continuous EEG monitoring were numerous, leading to status epilepticus in three babies.

Non-invasive measurement of haemodynamics during sleep apnoea.

Sleep apnoeas are accompanied by large variations in heart rate (HR) and blood pressure (BP). This nocturnal variability in BP may be involved in the increased cardiovascular morbidity of these patients. Due to the complex interaction between asphyxia, intrathoracic pressure, cardiac function and autonomic activation, the exact haemodynamic mechanisms are unclear.

[Nocturnal continuous measurement of blood pressure in sleep apnea syndromes. Comparison between normotensive and hypertensive patients].

Sleep apnea syndrome and systemic hypertension are frequently associated but their causal relationship is unclear. We compared the oscillations of systemic blood pressure and heart rate during polysomnography in 8 normotensive subjects (2 females) and 5 hypertensive (supine awake blood pressure: 165 +/- 7/96 +/- 5 mmHg) without treatment. Their ages (normotensive: 52.

Abdominal muscle activity during CO2 rebreathing in sleeping neonates.

Comparison of the abdominal muscle response to CO2 rebreathing in rapid-eye-movement (REM) and non-REM (NREM) sleep was performed in healthy premature infants near full term. Eight subjects were studied at a postconceptional age of 40 +/- 1.6 (SD) wk (range 38-43 wk) during spontaneous sleep.

Systemic hypertension in sleep apnea syndrome. Relationship with sleep architecture and breathing abnormalities.

To examine the possible relationship between systemic HT and SAS we compared 21 hypertensive (HT+) and 29 normotensive (HT-) patients for morphologic characteristics, sleep disturbances and respiratory events monitored during a full night polysomnography. There was no significant difference between HT+ and HT- patients with respect to age, weight, BMI, sleep stage distribution and disorganization, apnea-hypopnea index (number of episodes per hour of sleep) and duration (minutes per hour of sleep) nor O2 saturation indices: mean nocturnal and minimum O2 saturation. We conclude therefore that HT in SAS patients is not directly related to morphologic characteristics, sleep disturbances and breathing abnormalities.

Sleep-related abdominal muscle behavior during partial or complete obstructed breathing in prepubertal children.

We have evaluated the influence of nonrapid eye movement (NREM), REM sleep, and arousal on abdominal muscle contractions during snoring and/or obstructive apnea in 10 prepubertal children. All children were known habitual snorers and eight had a sleep apnea index above 10. During stage 3-4 non-REM sleep, non-apneic breathing with snoring was always associated with the presence of expiratory abdominal muscle electromyogram (EMG) discharges.