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Polygraphic Results in High-Risk Infants Aged Under 3 Months
Daniel Zenteno1,2, Gerardo Torres-Puebla2, Camila Sánchez1
1Department of Pediatrics, Faculty of Medicine, University of Concepción, Concepcion 4070409, Chile.
Insights
Cardiorespiratory polygraphy in infants under three months with suspected apneas revealed frequent abnormal findings. Infants with craniofacial alterations and laryngomalacia showed a significantly higher risk of abnormal polygraph results.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Neonatology
Background:
- Infants under three months hospitalized for suspected apneas undergo cardiorespiratory polygraphy (PG) for diagnosis.
- Understanding PG findings in this age group is crucial for accurate diagnosis and management.
Purpose of the Study:
- To analyze cardiorespiratory polygraphic study results in infants under three months hospitalized with suspected apneas.
- To compare PG findings across different diagnostic groups and identify risk factors for abnormal results.
Main Methods:
- A cross-sectional study included 155 infants (<3 months) hospitalized between 2011-2023 for suspected apneas.
- Cardiorespiratory polygraphies were performed, and data on demographics, PG values, and diagnoses were collected and analyzed.
- Statistical tests including Kruskal-Wallis, Wilcoxon, Fisher, Spearman's rho, and logistic regression were used to evaluate associations.
Main Results:
- The study included 155 infants, with 52.3% being premature. Common diagnoses included brief resolved unexplained events (BRUE), apnea of prematurity, hypotonic syndrome, laryngomalacia (LGM), and craniofacial alterations (CFA).
- 21.9% of polygraphies showed abnormal results, with 44.1% indicating an apnea-hypopnea index (AHI) ≥ 5/h and 20.6% showing SpO2 ≤ 90%.
- Patients with CFA and LGM had a significantly higher risk of abnormal polygraph findings compared to those with apnea of prematurity and BRUE, respectively.
Conclusions:
- Cardiorespiratory polygraphy is feasible and effective in infants under three months with suspected apneas, confirming apnea presence and severity.
- Abnormal polygraphic indices are common in this population, with significant variations between diagnostic groups.
- Infants with CFA and LGM require particular attention due to their elevated risk of abnormal sleep study results, suggesting potential age-specific apnea patterns warranting further investigation.
Abstract:
This study described and analyzed the results of cardiorespiratory polygraphic studies in infants under three months who were hospitalized and monitored due to suspected apneas.
Methods:
Cross-sectional study. Patients aged <3 months hospitalized from 2011 to 2023 were included. All were referred for suspected apneas, and cardiorespiratory polygraphies (PG) were conducted simultaneous to non-invasive monitoring. Demographic, PG, and diagnostic variables were recorded. PG values were obtained and compared between diagnostic groups. Association was evaluated according to diagnosis, prematurity, presence, and alteration type with Kruskal-Wallis, Wilcoxon, and Fisher tests. Association between quantitative variables was assessed with Spearman's rho and the presence of alteration with binomial logistic regression. Analysis was performed with Jamovi v.2.3, and statistical significance was defined as p < 0.05.
Results:
A total of 155 studies were included. Median age was 41.0 days (IQR 22.0-59.0), median gestational age was 38 weeks (IQR 32.0-42.0), and 52.3% were premature.
Diagnosis:
brief resolved unexplained events (BRUE) (58.1%), apnea of prematurity (27.1%), hypotonic syndrome (7.1%), laryngomalacia (LGM) (3.9%), and craniofacial alterations (CFA) (3.9%). Altered results in 21.9% polygraphies: 44.1% with AHI ≧ 5/h and 20.6% with SpO2 ≦ 90% in >5% of the record. CFA and LGM patients had a higher risk of an altered polygraph than those with apnea of prematurity (OR 21.3/8.5) and BRUE (OR 35.9/14.3), respectively.
Conclusions:
Infants under three months of age referred for apnea showed often abnormal polygraphic indices, showing significant differences between diagnostic groups. Performance of sleep studies in these groups was feasible and allowed to confirm the presence of apneas and their level of severity. Particular attention should be considered in children with CFA and LMG, since their risk is significantly higher. Age-specific apnea patterns seem to be of interest, as this may possibly lead to future consequences.
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