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Central apnea and periodic breathing in children with underlying conditions

Sergio Ghirardo1,2, Alessandro Amaddeo1,3, Lucie Griffon1,3

  • 1Assistance Publique-Hôpitaux de Paris (AP-HP), Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades, Paris, France.

Journal of Sleep Research
|June 2, 2021
PubMed

Insights

Central sleep apnea (CSA) is rare in children, affecting 3% of patients. This study characterized CSA and periodic breathing in children, finding varied causes and effective management strategies through sleep studies.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Physiology
  • Neurology

Background:

  • Central sleep apneas (CSA) and periodic breathing are under-described conditions in pediatric populations.
  • Understanding the prevalence, characteristics, and management of pediatric CSA is crucial for clinical practice.
  • Associated medical conditions can significantly influence the presentation and severity of these sleep-disordered breathing events.

Purpose of the Study:

  • To determine the prevalence and clinical characteristics of central sleep apnea and periodic breathing in children.
  • To investigate the association between central sleep apnea and specific medical conditions in pediatric patients.
  • To evaluate the therapeutic management strategies employed for central sleep apnea and periodic breathing in children.

Main Methods:

  • Retrospective review of poly(somno)graphies in children with a central apnea index ≥ 5 events/hr over a 6-year period.
  • Inclusion criteria: children > 1 month old undergoing polysomnography in a dedicated pediatric sleep laboratory.
  • Data collection included clinical information, sleep study results, and follow-up polysomnography findings.

Main Results:

  • Central sleep apnea was identified in 3% (95/2981) of pediatric patients, with 61% exhibiting an exclusive central pattern.
  • Chiari malformation was the most frequent diagnosis (13%); periodic breathing was present in 83% of affected children.
  • Children with encephalopathy and/or epilepsy showed the highest central apnea index and longest periodic breathing duration.

Conclusions:

  • Central sleep apnea in children is a rare condition encompassing diverse underlying pathologies.
  • Polysomnography is essential for accurate diagnosis, detailed characterization, and effective management of pediatric central sleep apnea.
  • Therapeutic interventions, including watchful waiting and specific medical or surgical treatments, can be effective in selected cases.

Keywords:
apnea patterncentral sleep apneachildinfantperiodic breathing

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