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Published on: July 18, 2014
Sleep in infants with congenital heart disease
Daisy Satomi Ykeda1, Geraldo Lorenzi-Filho, Antonio A B Lopes
1Physiotherapy Department, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil. daisyykeda302@hotmail.com
Insights
Infants with congenital heart disease often experience sleep-disordered breathing and oxygen desaturations. These sleep issues, particularly hypoxia, can significantly impact their health and development.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Neonatology
Background:
- Congenital heart disease (CHD) can affect infant development.
- Sleep-disordered breathing (SDB) and hypoxia are potential complications in infants with CHD.
Purpose of the Study:
- To investigate the prevalence of hypoxia and sleep-disordered breathing in infants diagnosed with congenital heart disease.
Main Methods:
- A prospective study involving 14 infants with CHD (7 acyanotic, 7 cyanotic) and 7 healthy controls.
- Full polysomnography was conducted to assess sleep parameters, including respiratory disturbance index (AHI) and oxygen saturation.
Main Results:
- Infants with CHD exhibited significantly lower nutritional status and minimum oxygen saturation compared to controls.
- The apnea-hypopnea index (AHI) was significantly higher in infants with CHD, indicating prevalent sleep-disordered breathing.
- While oxygen desaturations were common in CHD infants, arousal indices were similar across all groups.
Conclusions:
- Infants with congenital heart disease frequently experience sleep-disordered breathing and associated oxygen desaturations.
- Sleep disturbances, characterized by hypoxia, pose a significant burden on infants with CHD.
- Further research is warranted to explore interventions for managing sleep-related issues in this population.
Objectives:
To investigate hypoxia and sleep disordered breathing in infants with congenital heart disease.
Methods:
Prospective study. In-hospital full polysomnography was performed on 14 infants with congenital heart disease, age 7 +/-1 months, and in 7 normal infants, age 10 +/-2 months. Congenital heart disease infants were classified as acyanotic (n=7) or cyanotic (n=7).
Results:
Nutritional status, assessed by the Gomez classification and expressed as % weight for age, was 70 +/-7, 59 +/-11 and 94 +/-16 in the acyanotic, cyanotic congenital heart disease and control infants, respectively (p<0.001). The respiratory disturbance index (AHI, events per hour) was [median (25-75%)]: 2.5 (1.0-3.4), 2.4 (1.5-3.1) and 0.7 (0.7-0.9) in acyanotic, cyanotic CHD infants and controls, respectively (p=0.013). Almost all congenital heart disease infants (11 out of 14) and only one control infant had an AHI >1 event/hour. The minimum oxygen saturation was 79% (74-82), 73% (57-74) and 90% (90-91) in the acyanotic, cyanotic congenital heart disease infants and controls, respectively (p <0.001). The arousal index (events/hour) was similar among the three groups at 8.4 +/-2.4, 10.3 +/-8.7 and 6.5 +/-3, respectively (p=0.451).
Conclusions:
Infants with congenital heart disease frequently present with sleep-disordered breathing associated with oxygen desaturations but not arousals. Therefore, sleep may represent a significant burden to infants with congenital heart disease.
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