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Nasopharyngitis significantly increases prolonged sleep apnea episodes in infants. Apnea cessation occurs later during illness, suggesting an age-related susceptibility during upper respiratory infections.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Sleep Medicine
Background:
- Prolonged sleep apnea is a concern in infants.
- Nasopharyngitis, an upper respiratory infection, may influence apneic events.
Purpose of the Study:
- To investigate the impact of nasopharyngitis on prolonged sleep apnea in infants.
- To determine if illness affects the age-related cessation of apneic episodes.
Main Methods:
- Studied 26 infants on apnea monitors.
- Monitored apneic episodes during and outside of nasopharyngitis episodes.
- Analyzed frequency and age-related trends of prolonged apnea (≥20 seconds).
Main Results:
- Infants experienced significantly more prolonged apneic episodes during nasopharyngitis.
- Apneic episodes ceased at a later postnatal age during illness compared to illness-free periods.
- An age-related phase exists where infants experience apnea during nasopharyngitis.
Conclusions:
- Nasopharyngitis exacerbates prolonged sleep apnea in susceptible infants.
- Illness may delay the natural resolution of prolonged sleep apnea.
- Findings have implications for managing infant apnea and understanding SIDS risk during infections.
Abstract:
The effect of nasopharyngitis on the simultaneous occurrence of prolonged sleep apnea (greater than or equal to 20 seconds in duration) was studied in 26 infants managed at home on an apnea monitor. During the observation period, these infants had a total of 69 illnesses which appeared to represent an upper respiratory tract inflammatory process. In general, the daily frequency of prolonged apneic episodes was significantly greater during nasopharyngitis when compared to comparable time intervals immediately prior to and following the illness. In addition, there was a decrease in the frequency of apneic episodes with increasing postnatal age until the episodes finally ceased to occur during the illness-related intervals. Apneic episodes ceased to occur at an earlier age for the before- and after-illness intervals than for the time interval during which there were clinical symptoms. Thus, it would appear that infants go through an age-related phase wherein prolonged apnea occurs during nasopharyngitis but not when free of illness. The implications of these results for the management of infants having prolonged sleep apnea are discussed. In view of the hypothesis that prolonged sleep apnea is part of the physiological process resulting in the sudden infant death syndrome, these results also provide for the prediction that infants who suddenly die in association with nasopharyngitis would do so, in general, at a later age than those who succumb when free of an upper respiratory tract inflammatory process.