Infant sleep apnea profile: preterm vs. term infants

Abstract

By means of polygraphic sleep recording, the sleep apnea profile with respect to the number and duration of inactive, obstructive and mixed apneic episodes as well as periodic breathing has been investigated in infants born preterm at 40, 52 and 64 weeks conceptional age and compared to that of term infants. At 40 weeks preterm infants showed significantly more apnea and periodic breathing compared to term infants. The difference was essentially due to obstructive and mixed apnea in non-REM sleep. There was a sharp decrease in all apneic variables--inactive, obstructive and mixed apnea as well as of periodic breathing--at 52 weeks conceptional age in infants that were previously preterm. Both groups exhibited a rather identical sleep apnea profile at 64 weeks. Two prospectively studied infants in the preterm group later became SIDS victims. One of them might have been identified as being at risk on the basis of his apnea profile compared to the normative data now available.

Frequency of Obstructive and Mixed Sleep Apneas in 1,023 Infants

“…1,2,[8][9][10][11]14 Most previous studies were however done on small groups of infants and some studies did not differentiate obstructive from mixed events. 4,8,10,11,14 In the present report, obstructive apneas were almost twice as frequently found than mixed apneas.…”

“…The decrease in apnea frequency with age was also found in several studies, 4,10,11,14,19,21,22 but was not reported by all authors. Guilleminault et al reported an increase in obstructive and mixed apneas during night-time sleep at six weeks of age.…”

Periodic Breathing Cycle Duration in Preterm Infants

“…Second, PB occurs during both quiet sleep and active sleep in preterm infants; however, it is largely confined to active sleep in term infants (7,14,(26)(27)(28). Although Barrington et al (14) reported that PCD was not significantly influenced by sleep state in term infants, the higher amount of PB occurring in quiet sleep coupled with longer PB episodes in preterm infants compared to term infants suggests that sleep state could influence PCD variability, especially in light of the sleep state-dependent changes in respiratory control system characteristics which occur in both adults and infants (29).…”

“…PB comprises <2% of the respiratory pattern in most normal infants during the first months of life (1)(2)(3), and occurs more frequently and in higher amounts in preterm infants (4)(5)(6)(7)(8). PB may therefore reflect an immaturity of developing respiratory control system elements which does not normally indicate any abnormalities or pathology; however, elevated amounts of PB have been reported in some infants "near-miss" for SIDS and in some SIDS victims (9-1 3).…”

Periodic Breathing and Oxygen Saturation in Preterm Infants at Discharge

“…1 Preterm infants have significantly more PB when they reach term than infants who are born at term. 2 Hypoxia has been associated with an increased incidence of PB, 3 and PB by itself may cause episodes of hypoxemia. 4 We are unaware of any study that has reported on the pattern of oxygenation in preterm infants who have significant PB.…”