Sleep related expiratory obstructive apnea in children
Mark E Haupt1, Denise M Goodman, Stephen H Sheldon
1Division of Pulmonary Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL 60610, USA. mhaupt@luriechildrens.org
Summary
Prolonged expiratory apnea (PEA) and post-sigh central apnea (PSCA) in children show heart rate changes similar to pathological apneas but appear benign. Further research is needed to determine their clinical significance.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Cardiology
Background:
- Sleep-related breathing disorders are common in children.
- Prolonged expiratory apnea (PEA) and post-sigh central apnea (PSCA) can meet criteria for pathological apnea but may be benign.
- Characterizing these events is crucial for accurate diagnosis.
Purpose of the Study:
- To describe the respiratory, cardiac, and sleep-related characteristics of PEA and PSCA in children.
- To compare the physiological parameters of PEA and PSCA.
- To assess the potential benign nature of these respiratory events.
Main Methods:
- Retrospective review of overnight polysomnography in children without significant medical conditions.
- Identification of PEA and PSCA based on characteristic features.
- Recording and comparison of physiological parameters, including heart rate and oxygen saturation.
Main Results:
- Fifty-seven events (29 PEA, 28 PSCA) were identified in 17 children.
- No significant difference in median durations between PEA and PSCA.
- Both PEA and PSCA exhibited stereotypic heart rate changes, with PEA showing a lower lowest instantaneous heart rate during the pause.
- No events were associated with oxygen desaturation >3%.
Conclusions:
- PEA and PSCA demonstrate heart rate patterns resembling pathological apneas but appear to be benign in children.
- The clinical significance of PEA and PSCA requires further investigation.
- Consistent recognition is necessary due to their frequency and potential for misclassification.
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