Effect of Supplemental Oxygen on Sleep Architecture and Cardiorespiratory Events in Preterm Infants

Simakajornboon, Narong; Beckerman, Robert C.; Mack, C.; Sharon, Denise; Gozal, David

doi:10.1542/peds.110.5.884

Cited by 86 publications

(43 citation statements)

References 31 publications

(27 reference statements)

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“…estimated sleep time without movement or artifactual/uninterpretable periods, CEST) was calculated. A minimum of 4 h of CEST was required (16,17). For infants, it has been shown that reliability of apnea estimation is adequate when recording duration exceeds 3 hours (16 -18).…”

Section: Subjectsmentioning

confidence: 99%

Reference Values for Nocturnal Home Polysomnography in Primary Schoolchildren

et al. 2005

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Abbreviated home polysomnography may be an alternative to laboratory polysomnography in children but is not yet generally accepted, partly due to a lack of reference values. Also, there are no normative data on respiratory events obtained using nasal prongs. We determined the prevalence and frequency of central, obstructive, and mixed apneas and hypopneas in a populationbased sample of 50 children (mean age 10.1 years) using abbreviated home polysomnography and nasal prongs. We also determined the frequency of movements/arousals and body position changes. All children had central apneas. Obstructive apneas, mixed apneas, and hypopneas were found in 36%, 6%, and 14% of children, respectively. Average number of central, obstructive, and mixed apneas; hypopneas; movement/arousals; and body position changes per hour of sleep was 1.5, 0.1, 0.01, 0.02, 8.2, and 3.7, respectively. The corresponding cutoff values (mean plus 2 standard deviations or 95th centile) were 3.7, 0.7, 0.1, 0.2, 13.4, and 9.1, respectively. We did not find significant gender differences regarding any sleep variable under study. The presented reference values may help clinicians and researchers to improve the interpretation of abbreviated home polysomnography in school-age children. The gold standard for diagnosing sleep-disordered breathing (SDB) is full polysomnography in a sleep laboratory (1). Unattended home sleep studies using portable systems, however, are increasingly recognized as an alternative. Advantages include convenience, improved sleep quality, and costeffectiveness (2,3). Nonetheless, such studies are yet rarely used in the evaluation of pediatric SDB. One reason for this may be the lack of reference values.There are also no reference data for respiratory events in children measured by nasal prongs/pressure transducers, although these are more sensitive in detecting hypopnea and FL than thermal sensors (e.g. thermistor or thermocouples) (4,5). This is important because children are more likely than adults to have partial rather than complete upper airway obstruction (6).We, thus, aimed to establish reference values for respiratory and other sleep study variables obtained at home using portable devices and nasal prongs/pressure transducers. The current study was conducted as a part of a population-based crosssectional study on prevalence, risk factors, and consequences of various expressions of SDB in children (7-10). Primary school children were screened for signs and symptoms of SDB using parental questionnaires (8) and nocturnal home pulse oximetry (11). Children with and without signs and symptoms of SDB subsequently underwent nocturnal home polysomnography (8). In this report, we focus on the feasibility of performing unattended home sleep studies in children, the data quality achieved, and the presentation of reference values obtained from healthy school-age children. METHODS Subjects.The source population for the current study were subjects who had participated in the main study (8) and had (1) no history of habitual snorin...

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Section: Subjectsmentioning

confidence: 99%

Reference Values for Nocturnal Home Polysomnography in Primary Schoolchildren

et al. 2005

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“…This finding contradicts the substantial body of observational evidence suggesting that higher oxygen targeting can improve growth [30], ameliorate sleep pattern abnormalities [31] and reduce desaturation episodes [32].…”

Section: Tinmentioning

confidence: 61%

Optimal Oxygen Saturation for Preterm Babies

Tin

2004

Neonatology

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Oxygen is the most commonly used ‘drug’ in neonatal units as an integral part of respiratory support. It has also been known for half of the century that it is easy to damage the eyes of preterm infants by giving too much oxygen especially in the first few weeks of life. Despite this knowledge there is still a wide variation in approaches to oxygen monitoring within neonatal units. A randomized controlled trial conducted more than 50 years ago first made clinicians aware of ‘oxygen toxicity’ in preterm infants, but no other controlled trial has ever been conducted since to clarify how much oxygen infants really need, or what oxygen saturation level is optimal in caring these preterm babies. Perhaps time has come for clinicians to resolve this ‘uncertainty’ by well-designed randomized trials.

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“…These authors concluded that oxygen therapy may be a temporary palliative treatment for sleep apnea. Data from previously premature children studied at 38 weeks postconceptional age have also shown improvement in respiratory stability and sleep duration with low-flow oxygen therapy, without compromising alveolar ventilation [43].…”

Section: Oxygen Therapymentioning

confidence: 92%

Treatment of Childhood Obstructive Sleep Apnea

Daftary

Kotagal

2010

Curr Treat Options Neurol

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An array of surgical, medical and orthodontic treatments is available for treating childhood obstructive sleep apnea. Adenotonsillectomy remains the first choice in treatment, with a need for subsequent clinical and polysomnographic reassessment in selected cases to determine residual sleep-disordered breathing. Residual obstructive sleep apnea is more likely in patients with craniofacial abnormalities or obesity. It may require the use of a positive airway pressure breathing device. Topical corticosteroids, leukotriene antagonists, weight reduction, and positional therapy also play a role in ameliorating childhood obstructive sleep apnea. The published evidence for the efficacy of various treatment modalities consists largely of case-controlled studies and case reports.

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Effect of Supplemental Oxygen on Sleep Architecture and Cardiorespiratory Events in Preterm Infants

Cited by 86 publications

References 31 publications

Reference Values for Nocturnal Home Polysomnography in Primary Schoolchildren

Reference Values for Nocturnal Home Polysomnography in Primary Schoolchildren

Optimal Oxygen Saturation for Preterm Babies

Treatment of Childhood Obstructive Sleep Apnea

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