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Relevance of the pH probe in sleep study analysis in infants
1Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago. pharris@med.puc.cl
Insights
Infants experiencing sleep apnoea or life-threatening events often have gastro-oesophageal reflux. However, these gastro-oesophageal reflux episodes typically do not correlate with respiratory events, indicating they are separate conditions.
Area of Science:
- Pediatric Gastroenterology
- Sleep Medicine
- Neonatology
Background:
- Sleep apnoea and gastro-oesophageal reflux are common concerns in infants.
- Understanding their relationship is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the association between sleep apnoea and gastro-oesophageal reflux in infants.
- To characterize the clinical, demographic, and pHmetric profiles of affected infants.
- To analyze polysomnography findings in conjunction with pH monitoring.
Main Methods:
- A cohort of 102 infants underwent polysomnography with a pH probe.
- Parental questionnaires gathered information on symptoms and prior treatments.
- Gastro-oesophageal reflux was defined as >4% of total sleep time with pH < 4.
Main Results:
- The study included 102 infants (53% male), with a mean age of 2.6 months.
- Gastro-oesophageal reflux was present in 42% of infants (pathologic range), 36% had mild reflux, and 21.5% had no reflux.
- Only one infant showed a clear link between reflux and respiratory events with desaturation.
Conclusions:
- Infants with a history of apnoea or acute life-threatening events frequently exhibit gastro-oesophageal reflux.
- Gastro-oesophageal reflux and apnoea appear to be distinct events occurring concurrently in some infants.
- The findings suggest that these conditions often coexist but are not causally linked in most cases.
Background:
To establish the relationship between sleep apnoea and gastro-oesophageal reflux in infants and describe the clinical, demographic and pHmetric profile and the characteristic of the sleep polysomnography with a pH probe.
Methods:
A total of 102 consecutive patients were evaluated. Parents were requested to fill out a questionnaire about symptoms and previous therapy. Gastro-oesophageal reflux was considered abnormal when the percentage of time with pH less than 4 was higher than 4% of total sleep time.
Results:
A total of 102 infants were enrolled, 53% males. Seventy-four per cent of the infants were full-term babies. At the moment of the polysomnography, the mean age of the sample was 2.6 months. Suspicion of apnoea was the most common clinical diagnosis prior to the study. Only two infants have abnormal electroencephalogram. Mild gastro-oesophageal reflux was seen in 37 (36%) infants, while 22 (21.5%) did not have any reflux episode, and the remaining 43 (42%) infants had reflux index in the pathologic range. Only one patient had an unequivocal temporal relationship between acid oesophageal reflux and respiratory pause with oxygen desaturation.
Discussion:
Infants with history of apnoea or acute life threatening event frequently had gastro-oesophageal reflux episodes which did not correlated with respiratory events, suggesting that gastro-oesophageal reflux and apnoea often occur in the same infant as two separate events.
