Brief airway obstructions during sleep in infants with breath-holding spells

Kahn, André; Rebuffat, Elisabeth; Sottiaux, Martine; Muller, Marie-Françoise; Bochner, A.; Grosswasser, J.

doi:10.1016/s0022-3476(05)80528-1

Cited by 24 publications

(13 citation statements)

References 32 publications

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“…At the time of this study, there were no published alternative validated scales for OSA in this age group. Although noisy breathing or snoring remains the cardinal symptom of airway obstruction, children under 1 year of age exhibit a different profile of symptoms (Kahn et al, 1990(Kahn et al, , 1993 so our results are still likely to underestimate the true prevalence of OSA in this age group. Finally, because CL/P is a heterogeneous disorder with variations in the type and timing of surgery, the use of cross-sectional data to investigate age and surgical status as a risk factor for OSA is limited.…”

Section: Discussionmentioning

confidence: 81%

Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

MacLean

Waters

Fitzsimons

et al. 2009

The Cleft Palate-Craniofacial Journal

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Section: Discussionmentioning

confidence: 81%

Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

MacLean

Waters

Fitzsimons

et al. 2009

The Cleft Palate-Craniofacial Journal

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“…Intrapulmonary shunting [12], disorder of ventilator chemosensitivity [16], and autonomic dysregulation [17–19] are the postulated theories. Pallid breath holding spells are known to be caused by exaggerated vagal response leading to cerebral hypoperfusion [20].…”

Section: Discussionmentioning

confidence: 99%

Diverse Presentation of Breath Holding Spells: Two Case Reports with Literature Review

Rathore

Larsen

Fernández

et al. 2013

Case Reports in Neurological Medicine

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Breath holding spells are a common and dramatic form of syncope and anoxic seizure in infancy. They are usually triggered by an emotional stimuli or minor trauma. Based on the color change, they are classified into 3 types, cyanotic, pallid, and mixed. Pallid breath holding spells result from exaggerated, vagally-mediated cardiac inhibition, whereas the more common, cyanotic breathholding spells are of more complex pathogenesis which is not completely understood. A detailed and accurate history is the mainstay of diagnosis. An EKG should be strongly considered to rule out long QT syndrome. Spontaneous resolution of breath-holding spells is usually seen, without any adverse developmental and intellectual sequelae. Rare cases of status epilepticus, prolonged asystole, and sudden death have been reported. Reassurance and education is the mainstay of therapy. Occasionally, pharmacologic intervention with iron, piracetam; atropine may be of benefit. Here we present 2 cases, one of each, pallid and cyanotic breath holding spells.

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“…Several studies have shown that obstruc tive and mixed sleep apneas are rare in healthy infants [6][7][8]. Factors related to the development of obstructive apneas are the child's age, sex, and weight.…”

Section: Factors Associated With Sleep Apneasmentioning

confidence: 99%

Mechanisms of Obstructive Sleep Apneas in Infants

et al. 1994

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During sleep, infants with obstructive sleep apneas are characterised by snoring, laborious breathing, and profuse sweating. During wakefulness, they may have breath-holding spells, and during feeding, difficult breathing and swallowing coordination. Abnormal weight, difficult growth, and recurring ear infections may also develop. During sleep apneas, cinefiuoroscopy shows approximation of tongue and hypopharyngeal tissues, with an obliteration of the air space. The obstructed breaths occur mainly in REM, and light NREM sleep, associated with total short sleep time, and frequent arousals. Preterm infants, and term neonates are more prone to obstructive apneas than older healthy infants. Apneas are more frequently seen in boys and in case of excess in body weight. Obstructive apneas are frequently associated with upper airway anatomic abnormalities: malformations, soft tissue infiltration, and neurologic lesions impairing muscle contractions. Alterations of the autonomic nervous control may induce airways obstructions. Contributing factors include mucopolysaccharide storage disease, hypothyroidism, or Down’s syndrome. Superimposed factors may occur, such as nasal obstruction, secretions in the airways, or tissue edema. Pressure- and chemo-sensitive reflexes may also favor obstruction. Environmental factors also contribute to the development of sleep apneas: body position, neck flexion, sleep deprivation, or the effects of sedative drugs.

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Brief airway obstructions during sleep in infants with breath-holding spells

Cited by 24 publications

References 32 publications

Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

Diverse Presentation of Breath Holding Spells: Two Case Reports with Literature Review

Mechanisms of Obstructive Sleep Apneas in Infants

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