Breathing patterns and heart rates at ages 6 weeks and 2 years

Forty-two randomly selected, full-term, healthy infants underwent 24-hour electrocardiographic recordings and breathing movements at about ages 6 weeks (median age, 43 days; range, 34 to 61 days) and 2 years (median age, 26 months; range, 21 to 35 months). The number and duration of apneic pauses of 3.6 seconds or longer were analyzed. Periodic apnea was defined as a sequence of three or more apneic pauses, each separated by fewer than 20 breaths. All other apneic pauses were defined as isolated. Median heart rates and respiratory rates, which were measured during regular breathing, decreased from 137/min and 35/min to 98/min and 21/min, respectively. The total duration of periodic apnea remained unchanged (median, 0.06 min/h vs 0.05 min/h). Although the median frequency of all isolated apneic pauses decreased from 3.6/h to 2.5/h, the number of those that were longer than 6 seconds increased from 0.37/h to 0.80/h, leading to an increase in the proportion of these pauses, among all isolated apneic pauses, from 10% at age 6 weeks to 32% at age 2 years. Only one apneic pause in one infant at age 6 weeks, but eight pauses in six children at age 2 years, were longer than 15 seconds. A knowledge of such normal variability in the duration of apneic pauses in older infants and young children is essential for the interpretation of pneumograms and alarms while monitoring breathing movements.