Effect of Narcotic Withdrawal on Neonatal Sleep Patterns

Abstract

It i s known t h a t morphine and related compounds suppress REM sleep i n the adult. This study was undertaken t o determine if infants of heroin and methadone-addicted mothers would exhib i t a l t e r e d sleep patterns i n withdrawal. EOG, EMG, and r e s p i ra t i o n were recorded by multichannel polygraph on 10 i n f a n t s (4 methadone, 6 heroin) f o r 2%-4 hr. periods p r i o r to, during, and a f t e r chlorpromazine therapy (2.0 mg/kg/d). It was found t h a t heroin and methadone o b l i t e r a t e d REM sleep and t h a t periods o f q u i e t sleep were r a r e before treatment. After a minimum o f 48 hrs. therapy, b r i e f but i d e n t i f i a b l e periods of REM appeared, increasing i n frequency as successful withdrawal occurred. However REM occupied a maximum o f so o f sleep time.Since t h i s state i s normally present i n the newborn and i s thought t o be t h a t period o f sleep i n which neuronal p r o t e i n synthesis i s most active, and since heroin and methadone suppress REM, i t was concluded t h a t suitable treatment o f withdrawal i s essential, not simply t o r e l i e v e symptoms, but also t o promote more normal and necessary sleep patterns during t h i s c r i t i c a l time o f brain development. This may, indeed, be especially valuable f o r those i n f a n t s already demonstrating i n t r a u t e r i n e growth retardation w i t h maternal addiction. The effects of new environmental agents on child health i s a subject of considerable interest. Of special concern are the long-term effects of such agents and more specifically t h e i r carcinogenicity, mutagenicity, and teratogenicity which i s a function of t h e i r a b i l i t y t o modify cellular DNA. The purpose of t h i s study i s t o determine the effects of b i l irubin and/or i t s photodecomposition products on the u l t r as t r u c t u r a l arrangement of the DNA molecule. Mammalian and bacterial DNA solutions were illuminated under a phototherapy unit (Vita-Lite), 2pU/cn? in the 410-500 n m wavelength band f o r 6 hours in the presence or absence of bilirubin. Bilirubin was found t o form a complex with the DNA molecule and in the presence of l i g h t there results: ( 1 ) a decrease in the sedimentation coefficient of the DNA, ( 2 ) an increase in the thermal denaturation temperature and ( 3 ) no significant change in the buoyant density. These findings suggest t h a t the billrubin-DNA complex results from the intercalation of the bilirubin between the D N A strands. Upon irradiation the bilirubin i s activated and t h i s i s accanpanied by a cleavage of phosphodiester bonds which maintain the DNA structure. Studies on the mutagenicity of bilirubin and i t s photodegradation products are proceeding. These observations emphasize the importance of long-term follm-up i n children with hyperbilirubinemia treated with phototherapy. DAMAGE EFFECT OF BICARBONATE INFUSION IN NEUBaRN DOCS. Jc.n.Steichen and Uonard I. Kleinrun, Univ. of Cincinnati College of hkdicine, Depsrtmnt of Pediatrics. Cincinnati. Ohio....

Sleep deprivation, disorganization and fragmentation during opiate withdrawal in newborns

“…The examination of sleep in opiate‐exposed infants described in the present study is the most recent (no other studies have been carried out over the last 11 years) and has overcome the limitations of the previous four studies in this area 7–10 11 The present study is the first to measure the amount of wakefulness and number of arousals in newborns during acute opiate withdrawal.…”

“…There have been four studies that have examined sleep in newborn infants withdrawing from opiates 7–10 . Only two of the four studies used current and reliable techniques for measuring and scoring newborn sleep as outlined by Anders and associates 7,9,11 …”

Fetal Exposure to Narcotics: Neonatal Sleep as a Measure of Nervous System Disturbance

“…14, 227 (1960); we used a modification of this technique involving small inconspicuous spots at the wing bases. 6. Age is determined by subtracting the date on which a butterfly was first captured from the date in question.…”

“…Five (5.2 percent) experimental and five control individuals were captured by a nonvisual predator, a strategically located female orb-weaving spider (Argiope argentata, Araneae), during the course of the study. 16 (5), a recent study reported a decrease in REM in newborns exposed to heroin and methadone in utero (6). Consequently, the precise nature of sleep disturbance during narcotic withdrawal in neonates remains unclear;…”

Influence of Drugs on Brain Neurotransmitters and Behavioral States during Development1

“…A significant decrease in QS and increased REM was found in neonates prenatally exposed to opiates, a profile shared by many newborn at high risk for central nervous system impairment [Schulman, 1969;Dinges et al, 1980]. A decrease in both QS and REM was found in new born babies born to addicted mothers [Sisson et al, 1974], Sisson con cluded that since protein synthesis is stimulated during REM, treatment of withdrawal may be essential not only to relieve symptoms but also to pro mote normal and necessary sleep patterns required for brain development [Mirmiran et al, 1983]. Disturbances of the sleep-wake pattern with increased motor activity during sleep and increased sleep complaints have also been found in children born to hypertensive mothers treated with clonidine or a-methyldopa [Huisjes et al, 1984;Shimohira, 1984], Despite growing literature in the field of human behavioral teratoge nicity it is very difficult to be certain about a causal relationship between pre-and perinatal drug exposure and behavioral outcomes.…”