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Apnea in subsequent asymptomatic siblings of infants who had an apparent life-threatening event

J C Duke1, K C Sekar, P L Toubas

  • 1Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City 73190.

Journal of Perinatology : Official Journal of the California Perinatal Association
|June 1, 1992
PubMed

Insights

Infants with apparent life-threatening events (ALTE) and their siblings do not show increased apnea or periodic breathing. Sleep studies for siblings of ALTE infants are generally unnecessary unless parents disagree on risk.

Area of Science:

  • Pediatrics
  • Sleep Medicine
  • Neonatology

Background:

  • Infants experiencing apparent life-threatening events (ALTE) exhibit higher rates of periodic breathing and obstructive apnea compared to healthy infants.
  • It is unknown if these respiratory characteristics are present in siblings of infants who have experienced ALTE.

Purpose of the Study:

  • To compare the apnea indices of infants with ALTE and their subsequent asymptomatic siblings.
  • To determine if siblings of ALTE infants share similar respiratory patterns during sleep.

Main Methods:

  • Retrospective comparison of polygraphic sleep apnea evaluations in 13 first-born infants with ALTE and their siblings.
  • Evaluations included electrocardiogram, chest wall movements, expired CO2, and pulse oximetry.
  • Comparison of gestational age, birthweight, age at study, apnea and periodic breathing indices, and oxygen desaturations.

Main Results:

  • Regression analysis indicated that differences in apnea indices between ALTE infants and their siblings were eliminated after adjusting for gestational and postnatal age.
  • Both ALTE infants and their siblings demonstrated similar, non-elevated rates of apnea, prolonged central apneas (>10 seconds), and periodic breathing (>5% sleep time).
  • Neither group experienced subsequent severe apneas.

Conclusions:

  • Infants with ALTE and their siblings exhibit similar apnea and periodic breathing indices when adjusted for age.
  • Routine polygraphic sleep studies and cardiac/apnea monitoring for siblings of ALTE infants are not indicated.
  • Such monitoring should be reserved for situations with parental disagreement regarding risk assessment.

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