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Polysomnographic findings in 320 infants evaluated for apneic events
Ignacio Sanchez1, Luis Vega-Briceño, Carla Muñoz
1Section of Pulmonology, Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. igsan@med.puc.cl
Insights
Most infants referred for apnea or cyanotic events have normal polysomnography (PSG) findings. This study highlights the need for further research into the correlation between PSG results and long-term outcomes in these infants.
Area of Science:
- Pediatric Sleep Medicine
- Neonatology
Background:
- Infant apnea and cyanotic events are common causes of parental anxiety.
- Polysomnography (PSG) is a key diagnostic tool for evaluating these events.
Purpose of the Study:
- To describe polysomnographic findings in infants referred for apnea and/or cyanotic events.
- To test the hypothesis that most infants referred for these events have normal PSG results.
Main Methods:
- A prospective study of 320 infants under 2 years old referred for apnea/cyanotic events.
- Infants underwent computerized polysomnography (PSG), with 78% including a pH probe.
- Data collected included sleep stages, sleep efficiency, and apnea index.
Main Results:
- A high prevalence of normal PSG findings was observed in the study population.
- The median apnea index was 1.01, with most studies revealing no significant abnormalities.
- Differences in sleep efficiency and REM sleep time were noted between day and overnight PSG.
Conclusions:
- The study indicates that normal PSG findings are common in infants referred for apnea/cyanotic events.
- Further prospective studies are needed to correlate PSG findings with long-term outcomes.
- This research contributes to understanding the diagnostic yield of PSG in this pediatric population.
Abstract:
Apnea is a common problem that causes significant parental anxiety. The aim of this study was to describe polysomnographic findings in infants who were referred over a 4-year period for an apnea and/or cyanotic event. Our hypothesis was that most infants with apnea or cyanosis events will have normal polysomnography (PSG). In total, 320 patients younger than 2 years old were recruited sequentially and prospectively. Patients underwent a day or overnight PSG by computerized polysomnograph; 78% of studies were performed with pH probe in situ. Subjects' ages ranged from 10 days to 21 months (55% male and 84% full-term babies); 55% and 74% were younger than 3 and 6 months, respectively. The average total sleep time was 473.4 min (SD, 52.3), with mean sleep efficiency of 83.5%. The distribution of sleep stages was 56.5% active, 38.5%, quiet and 5.1% indeterminate sleep. Sixty-nine percent (n = 220) of PSG studies were done overnight. There were significant differences in average sleep efficiency (78.1% vs. 83.3%) and REM sleep time (63.6% vs. 59.1%) between PSGs done during the day and overnight (P < 0.05). In total, 34 patients with apneas were studied. The median apnea index for the whole study population was 1.01 (range, 0.1-9.1). In conclusion, our study showed a high prevalence of normal polysomnographic findings in infants referred because of apnea and/or cyanotic events. New clinical prospective studies should be conducted to evaluate whether there is a correlation between PSG findings and outcome at follow-up of infants with a history of apnea and cyanosis.
