Combined disturbance of respiratory regulation and esophageal function in early infancy.

An evident coincidence exists between increased and extended apneas during sleep and frequent gastroesophageal reflux as well as disturbances of propulsive esophageal peristalsis. The tendency to develop apnea and disturbed esophageal function are related to the degree of the maturity of the patient. This indicates that in some infants, a combined regulatory immaturity of the autonomic centers persists. Moreover, the gastroesophageal reflux fosters the clinical manifestation of sleep apneas. The risk of a reflex apnea accompanied by gastroesophageal reflux increases in proportion to the disturbance in the central respiratory regulation present at the same time. This pathomechanism can be considered one of the causes of the sudden infant death syndrome. The possibility of effective prophylaxis consists in treating the apneic tendency with aminophylline and the treatment of reflux by elevating the upper body and thickening the nourishment given.