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A developmental study on types and frequency distribution of short apneas (3 to 15 seconds) in term and preterm
D Lee1, R Caces, K Kwiatkowski
1University of Manitoba, Department of Pediatrics, Women's Hospital, Winnipeg, Manitoba, Canada.
Insights
Infant apneas are mostly central, occurring more frequently in preterm infants than term infants. Breath-holding apneas were more common in term infants, while central apnea rates decreased with age in preterm infants.
Area of Science:
- Neonatal Physiology
- Sleep Medicine
- Respiratory Control
Background:
- Apneas are common in infants, particularly preterm infants.
- Understanding the types and frequency of apneas is crucial for infant health.
- Previous research has not fully detailed the distribution and ventilatory correlates of various apnea types in early infancy.
Purpose of the Study:
- To measure the frequency distribution of different apnea types (central, obstructive, mixed, breath-holding) during sleep in term and preterm infants.
- To analyze the ventilatory correlates of these apneas.
- To examine changes in apnea frequency and type with postconceptual age.
Main Methods:
- Studied eight term and eight preterm infants from birth to 56 weeks postconceptual age.
- Utilized a modified flow-through system to record breathing during quiet sleep and rapid eye movement sleep.
- Analyzed over 783 apneas in term infants and 4086 apneas in preterm infants.
Main Results:
- The majority of apneas were central (82% in term, 93% in preterm infants).
- Preterm infants had a higher overall apnea rate than term infants.
- Central apnea rates decreased with postnatal age in preterm infants, but not significantly in term infants.
- Breath-holding apneas were more prevalent in term infants compared to preterm infants.
Conclusions:
- Apneas in newborns and early infancy are predominantly central and more frequent in preterm infants.
- The distribution of apnea types differs between term and preterm infants.
- Central apneas show a modal duration around 8 seconds in the first month of life for both groups.
Abstract:
We measured the frequency distribution and the ventilatory correlates of the various types of apneas 3 to 15 s long during sleep in eight term infants (birth weight 3.65 +/- 0.16 kg; gestational age 39.5 +/- 0.3 wk) and eight preterm infants (birth weight 2.07 +/- 0.18 kg; gestational age 34.3 +/- 0.4 wk). Each infant was studied on five to seven occasions from birth to 56 wk of postconceptual age using a modified flow-through system. Sixty-six paired epochs of quiet sleep (1163 min) and rapid eye movement sleep (829 min) were analyzed in term infants and 85 paired epochs of quiet sleep (1553 min) and rapid eye movement sleep (1328 min) in preterm infants. Of the 783 apneas recorded in term infants 82% were central, 1.5% obstructive, 0.5% mixed, and 16% were of the breath-holding type; the corresponding figures for the 4086 apneas recorded in preterm infants were 93, 0.5, 1.0, and 5.5%. This distribution was similar in the two sleep states but term infants had a higher percentage of breath-holding apneas than preterm infants (p less than 0.01). In preterm infants the rate of central apneas decreased with postnatal age (p less than 0.01); in term infants the rate did not change significantly. The duration of apneas showed a modal distribution for central apneas at about 8 s for both groups during the 1st month of life (p less than 0.05). The findings suggest: 1) apneas in the newborn and early infancy are primarily central and are more frequent in preterm than in term infants.(ABSTRACT TRUNCATED AT 250 WORDS)