Sleep in Infants with Congenital Heart Disease

Abstract

OBJECTIVES:To investigate hypoxia and sleep disordered breathing in infants with congenital heart disease.METHODS:Prospective study. In-hospital full polysomnography was performed on 14 infants with congenital heart disease, age 7 ±1 months, and in 7 normal infants, age 10 ±2 months. Congenital heart disease infants were classified as acyanotic (n=7) or cyanotic (n=7).RESULTS:Nutritional status, assessed by the Gomez classification and expressed as % weight for age, was 70 ±7, 59 ±11 and 94 ±16 in the acyanotic, cyanotic congenital heart disease and control infants, respectively (p<0.001). The respiratory disturbance index (AHI, events per hour) was [median (25–75%)]: 2.5 (1.0–3.4), 2.4 (1.5–3.1) and 0.7 (0.7–0.9) in acyanotic, cyanotic CHD infants and controls, respectively (p=0.013). Almost all congenital heart disease infants (11 out of 14) and only one control infant had an AHI >1 event/hour. The minimum oxygen saturation was 79% (74–82), 73% (57–74) and 90% (90–91) in the acyanotic, cyanotic congenital heart disease infants and controls, respectively (p <0.001). The arousal index (events/hour) was similar among the three groups at 8.4 ±2.4, 10.3 ±8.7 and 6.5 ±3, respectively (p=0.451).CONCLUSIONS:Infants with congenital heart disease frequently present with sleep-disordered breathing associated with oxygen desaturations but not arousals. Therefore, sleep may represent a significant burden to infants with congenital heart disease.

Neurodevelopmental evaluation strategies for children with congenital heart disease aged birth through 5 years: recommendations from the cardiac neurodevelopmental outcome collaborative

“…8,12,33,39 Young children also present to cardiac neurodevelopmental programs with dysregulated sleep patterns and with separation or medical anxiety. 24,33,39,45,48,76,77 Once children reach preschool, grade retention is often considered by parents, sometimes at the recommendation of schools or providers. Grade retention recommendations are most common among children with histories of repeat or prolonged hospitalisations, and who have reduced stamina and endurance.…”

Sleep-Disordered Breathing is Associated With Increased Mortality in Hospitalized Infants With Congenital Heart Disease

“…13 Although there are no large-scale studies of prevalence of SDB in infants with CHD, in a small prospective study, 79% of infants with CHD being evaluated for cardiac surgery were found to have comorbid SDB. 14 This high prevalence of obstructive sleep apnea in infants with CHD may be related to craniofacial abnormalities, the most common noncardiac malformation among children with CHD. 15 This phenotype may also be related to underlying neural crest cell migration defects that contribute to both CHD and airway abnormalities.…”

Avaliação dos artigos de pneumologia publicados em periódicos Brasileiros além do Jornal Brasileiro de Pneumologia

“…(2) The presence of associated diseases, such as rhinitis (symptoms are present in 90% of cases), gastroesophageal Sleep 5 [16][17][18][19][20] Physiology, exercise, and rehabilitation 12 [21][22][23][24][25][26][27][28][29][30][31][32] COPD 8 [33][34][35][36][37][38][39][40] Pathology 3 [41][42][43] CT 2 [44][45] Occupational medicine 1 46 Pulmonary thromboembolism 2 [47][48] Pulmonary hypertension 3 [49][50][51] Lung cancer 3 [52][53][54] Smoking 2 [55][56] Evaluation of articles on pulmonology published in Brazilian In their study involving patients with severe OSAS, Neves et al found that the use of sildenafil worsens OSAS, as well as causing deleterious cardiovascular effects because of the increased parasympathetic tone and affecting the HR variability. (19) Pires et al, in a study of drivers engaged in night shift work, contradicted the notion that the sleep pattern of older individuals is more negatively affected than that of younger individuals.…”

“…(16) Ykeda et al demonstrated that children with congenital heart disease have frequent episodes of apnea and hypopnea, as well as desaturation during sleep. (17) In their study, Jesus et al concluded that the clinical diagnosis of OSAS (as determined by the Berlin questionnaire) in patients with acute coronary syndrome was associated with a higher incidence of cardiovascular events during hospitalization. (18) …”