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Sleep-disordered breathing and upper-airway anomalies in first-degree relatives of ALTE children

C Guilleminault1, R Pelayo, D Leger

  • 1Stanford University Sleep Disorders Center, 401 Quarry Road, Suite 330, Stanford, CA 94305, USA. cguil@stanford.edu

Pediatric Research
|June 23, 2001
PubMed

Insights

Family history of sleep-disordered breathing (SDB) and small upper airways are risk factors for apparent life-threatening events (ALTE) in infants. Relatives of infants with SDB showed higher rates of SDB treatment and asthma.

Area of Science:

  • Pediatrics
  • Sleep Medicine
  • Genetics

Background:

  • Apparent life-threatening events (ALTE) in infants are a significant clinical concern.
  • Sleep-disordered breathing (SDB) is increasingly recognized as a potential contributor to ALTE.
  • Genetic and familial predispositions to SDB warrant further investigation.

Purpose of the Study:

  • To investigate the familial aggregation of sleep-disordered breathing (SDB) in infants experiencing apparent life-threatening events (ALTE).
  • To identify potential risk factors, including craniofacial and respiratory traits, within the families of infants with ALTE and SDB.

Main Methods:

  • Systematic investigation of relatives (parents, siblings, grandparents) of infants with ALTE.
  • Clinical evaluation, craniofacial assessment, and a validated sleep/wake questionnaire administered to relatives.
  • Infants with ALTE were categorized into groups based on polygraphic recordings: Group A (no SDB) and Group B (SDB positive).

Main Results:

  • 43% of relatives from Group B (infants with SDB) had a history of SDB treatment, compared to 7.1% in Group A (infants without SDB).
  • Families of Group B infants showed a significantly higher prevalence of small upper airways and asthma.
  • Naso-oro-maxillomandibular anatomic traits associated with small upper airways in parents were identified as potential risk factors.

Conclusions:

  • Familial aggregation of SDB is evident in infants with ALTE.
  • Inherited craniofacial and upper airway characteristics may increase an infant's risk for SDB and subsequent ALTE.
  • Screening for SDB and related traits in families of infants with ALTE is recommended.

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