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Apnea and periodic breathing in normal full-term infants during the first twelve months
Insights
Pediatric pneumograms help diagnose infant apnea. Normative values show periodic breathing decreases with age, while apnea and bradycardia are rare in healthy full-term infants.
Area of Science:
- Pediatric Sleep Medicine
- Neonatology
- Respiratory Physiology
Background:
- The pediatric pneumogram is crucial for diagnosing and managing infant apnea.
- Establishing normative data for breathing patterns in infants is essential for accurate clinical interpretation.
Purpose of the Study:
- To establish normative values for apnea, periodic breathing, and bradycardia in full-term infants.
- To analyze the influence of age and sex on these respiratory parameters during the first year of life.
Main Methods:
- Analysis of 287 pneumographic recordings from 123 full-term infants (0-52 weeks).
- Comparison of breathing patterns (apnea, periodic breathing, bradycardia) by infant sex and age.
- Statistical analysis to determine significant changes over time and between groups.
Main Results:
- Periodic breathing significantly decreased with age (78% at 0-2 weeks to 29% at 39-52 weeks).
- No apnea events >= 15 seconds were observed; apnea density did not vary with age or sex.
- No bradycardia was identified using the study's definitions.
Conclusions:
- Normal full-term infants may exhibit brief apneas (10-12 seconds) and some periodic breathing (<1% sleep time) up to 6 months.
- The study provides valuable normative data for interpreting pediatric pneumograms in infants.
- Periodic breathing prevalence declines significantly in the first year, but its duration relative to sleep time remains stable.
Abstract:
The pediatric pneumogram is a frequently used tool in the diagnosis and management of apnea during infancy. We analyzed 287 pneumographic recordings from 123 full-term infants (63 males) obtained during the first 12 months of life to establish normative values for apnea, periodic breathing, and bradycardia. The results of the analysis were compared by sex and age. The number of infants who exhibited periodic breathing decreased significantly over time (78% at 0-2 weeks vs 29% at 39-52 weeks; P less than 0.05). However, for those infants who did breathe periodically, the percent of sleep time spent in this breathing pattern did not change with age. No apnea greater than or equal to 15 seconds was recorded in any infant, and apnea density (total apnea greater than or equal to 10 seconds in minutes/100 minutes sleep time) did not change with age or sex. Using our definitions, no bradycardia was identified. Normal full-term infants occasionally have apnea of 10, 11, or 12 seconds, and, until 6 months of age, the majority will have a small amount of periodic breathing (less than 1% of sleep time) during sleep at home.