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The sleep state characteristics of apnea during infancy
Insights
Infant sleep apnea duration and frequency vary by sleep state and post-conceptional age. Longer apneas, particularly in REM sleep, decrease significantly with maturation by 52 weeks.
Area of Science:
- Pediatric Sleep Medicine
- Neonatal Physiology
- Respiratory Control
Background:
- Infant sleep apnea is influenced by sleep state and post-conceptional age.
- Apnea definitions vary based on duration, sleep state, and age.
Purpose of the Study:
- To investigate the sleep state characteristics of infant sleep apnea.
- To analyze the effect of maturation on apnea events from 40 to 52 weeks post-conception.
Main Methods:
- Polygraphic recordings were used to examine 36 twin infants.
- Data collected at 40, 44, and 52 weeks post-conception.
Main Results:
- Apnea duration over 10 seconds was uncommon; brief apneas (2-4.9s) were most frequent in REM sleep.
- Longer apneas (≥10s) decreased significantly in REM sleep by 52 weeks (0%), while quiet sleep apnea remained unchanged.
- Maturation impacted REM sleep apnea duration differently, with longer events decreasing notably.
Conclusions:
- The maturation effect on infant sleep apnea is state-dependent.
- REM sleep may have semi-independent apnea regulation mechanisms.
- No correlation was found between longer apneas (≥5s) across different ages for all sleep states.
Abstract:
The sleep state characteristics of infant sleep apnea were studied in 36 twins examined by polygraphy at 40, 44, and 52 weeks after conception. The definition of sleep apnea is dependent upon the length of apnea, sleep state, and post-conceptional age. None of the infants had apnea longer than 20 seconds and apnea of 10 seconds or longer was uncommon. The attack rates for apneas 2 to 4.9 seconds long were highest in REM and lowest in qliet sleep. The attack rates for apneas 5 to 9.9 seconds long were equal in REM and indeterminate and lowest in quiet sleep. The percentage of infants with apnea of 10 seconds or longer at 40 weeks was highest in REM (27%) and indeterminate sleep (42%) and lowest in quiet sleep (12%). At 52 weeks, apnea 10 seconds or longer during REM decreased to 0%. The effect of maturation on apnea varies with sleep state. Over the period from 40 to 52 weeks, quiet sleep apnea was unchanged and indeterminate sleep apnea decreased only between 40 and 44 weeks. Although REM apnea 2 to 4.9 seconds long was unchanged, REM apnea 5 to 9.9 seconds long decreased between 40 and 44 weeks, and REM apnea of 10 seconds or longer decreased from 27% at 40 weeks to 0% at 52 weeks. This suggests that semi-independent apnea turn-on and turn-off mechanism operate during REM sleep. A correlation between brief apneas and the longer apneas was seen only during REM sleep. For all sleep states, there was no correlation between the levels of apnea of 5 seconds or longer at 40, 44, and 52 weeks.