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Sleep apneas in normal neonates and infants during the first 3 months of life
Insights
Infant sleep breathing patterns show higher apnea events in active sleep and decrease by two months. Premature infants exhibit more breathing irregularities in early life.
Area of Science:
- Neonatal physiology
- Sleep medicine
- Respiratory control
Background:
- Normal full-term infant sleep breathing patterns are not well-documented.
- Understanding respiratory events during sleep is crucial for infant health.
Purpose of the Study:
- To analyze central apneas in full-term infants across different sleep states and developmental stages.
- To establish normative data for infant sleep-related breathing events.
Main Methods:
- Polygraphic sleep recordings of 52 full-term infants aged 2 days to 13 weeks.
- Analysis of central apneas (≥2 sec) in Active Sleep (AS), Quiet Sleep (QS), and Transitional Sleep (TS).
- Calculation of Apnea Index (AI) and Number of Apneas (NA); assessment of Periodic Breathing (PB).
Main Results:
- Higher AI and NA for short apneas (<5 sec) observed in AS compared to QS.
- Apnea events decrease by the second month of life in both AS and QS.
- Infants born at 38-39 weeks GA showed higher AI, NA, and %PB in the first five weeks compared to those born at 40-42 weeks GA.
- Positive correlation found between short and longer apneas in AS and total sleep.
- Obstructive and mixed apneas were rare; no effect of recording technique, sex, or position.
Conclusions:
- Infant sleep breathing patterns mature significantly within the first two months.
- Gestational age influences early postnatal respiratory patterns.
- Significant interindividual variability in apnea events exists, especially in the first month.
Abstract:
Sleep polygraphic recording was carried out on 52 normal full-term babies. 16 infants were recorded at 2 - 7 days of age, 14 at 2 to 5 weeks, 13 at 6 to 9 weeks and 9 at 10 - 13 weeks. Central apneas of 2 sec and over were analysed in Active Sleep (AS), Quiet Sleep (QS) and Transitional Sleep (TS). Apnea Index (AI, percent of non-breathing) and Number of Apneas (NA) per 100 min of sleep state (for 2 - 4 sec, greater than or equal to 5 sec, greater than or equal to 6 sec and greater than or equal to 10 sec apneas) were determined. Obstructive and mixed apneas were tabulated separately. % of Periodic Breathing (PB) was also determined. These results were statistically tested using different methods. AI and number of less than 5 sec apneas are higher in AS than in QS during the period studied. A decrease of AI and NA occurs before the end of the 2nd month both in AS and QS. During the first five weeks of postnatal life the AI, the NA and the % of PB are higher in infants born at 38 - 39 weeks of Gestational Age (GA) than in infants born at 40 - 42 weeks. A positive correlation between short apneas (less than 5 sec) and apneas greater than or equal to 5 sec was found in AS and in total sleep. Obstructive and mixed apneas were very infrequent. Apneas are not affected by recording technique, sex or sleeping position of infants. There is a great interindividual variability of NA, particularly during the first month of life. Little normative data has been published so far concerning the incidence of respiratory apneas during day sleep in full-term infants recorded by polygraphy.