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Markers for severity of illness associated with decreased snoring in toddlers born ELGA

Katherine Wang1, Juliann M Difiore, Richard J Martin

  • 1Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA. kwangstarks@gmail.com

Acta Paediatrica (Oslo, Norway : 1992)
|September 27, 2012
PubMed

Insights

This study found that female sex is linked to increased loud snoring in extremely low gestational age infants. Surprisingly, severe illness markers appear protective against loud snoring in this population.

Area of Science:

  • Neonatology
  • Pediatric Sleep Medicine
  • Respiratory Physiology

Background:

  • Sleep disordered breathing (SDB) is a concern in preterm infants.
  • Risk factors for SDB in extremely low gestational age (ELGA) infants require further investigation.
  • Early neonatal oxygen exposure (hypoxia/hyperoxia) is a potential contributing factor.

Purpose of the Study:

  • To determine the prevalence of sleep disordered breathing symptoms in infants born at extremely low gestational age.
  • To identify neonatal risk factors associated with SDB symptoms, including oxygenation.
  • To explore the relationship between neonatal illness severity and SDB symptoms.

Main Methods:

  • Monitoring of ELGA infants (<28 weeks gestation) using high-resolution pulse oximetry for the first 4 weeks.
  • Quantification of hypoxia (SaO2 < 80%) and hyperoxia (SaO2 > 98%) exposure.
  • Assessment of SDB symptoms using the OSA-18 questionnaire at 18-22 months corrected age.
  • Logistic regression analysis to identify risk factors for SDB symptoms.

Main Results:

  • 138 out of 182 ELGA infants (76%) completed the SDB symptom questionnaire.
  • The most common symptoms were restless sleep (24%) and loud snoring (21%).
  • Female sex was associated with a higher risk of loud snoring (OR 2.7).
  • Prolonged mechanical ventilation, necrotizing enterocolitis, and prolonged caffeine use showed an inverse correlation with loud snoring.
  • Neonatal hypoxia and hyperoxia were not significantly associated with SDB symptoms.

Conclusions:

  • The prevalence of SDB symptoms in ELGA infants is comparable to existing literature.
  • A previously unreported sex difference in loud snoring prevalence was identified.
  • Markers of neonatal illness severity appeared to be protective against loud snoring, contrary to expectations.
Abstract

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