Sleep disordered breathing in bronchopulmonary dysplasia

Area of Science:

• Pediatric Pulmonology
• Sleep Medicine
• Neonatology

Background:

• Limited data exist on the impact of bronchopulmonary dysplasia (BPD) on sleep disordered breathing (SDB).
• Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
• Sleep disordered breathing (SDB) encompasses conditions like sleep apnea and hypoventilation during sleep.

Purpose of the Study:

• To investigate the association between bronchopulmonary dysplasia (BPD) severity and the likelihood of sleep disordered breathing (SDB) in early childhood.
• To explore demographic factors influencing the development of SDB in children with BPD.

Main Methods:

• Retrospective analysis of patient data and overnight polysomnogram (PSG) results from a BPD registry (2008-2015).
• Utilized multiple linear regression to assess the relationship between PSG findings and patient variables.
• Included 140 children with BPD who underwent at least one sleep study.

Main Results:

• Elevated respiratory disturbance index (RDI) observed in the BPD population (mean 9.9 events/hr).
• Increased severity of respiratory disease correlated with more central events.
• Secondhand smoke exposure was linked to lower oxygen saturation nadirs and more desaturation events.
• Racial differences noted: non-white subjects had higher obstructive apnea-hypopnea index (OAHI), while white subjects had more central events.

Conclusions:

• The study population with BPD exhibited elevated RDI compared to non-preterm norms.
• BPD severity, environmental smoke exposure, and race are potential factors exacerbating SDB.
• While RDI improved with age, it remained elevated by age 4, indicating a persistent risk for SDB sequelae in this population.