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Pathologic apnea and brief respiratory pauses in preterm infants: relation to sleep state
D Holditch-Davis1, L J Edwards, M C Wigger
1School of Nursing, University of North Carolina at Chapel Hill.
Insights
Apnea in preterm infants is complex, varying with sleep state and decreasing with age. Factors like sex and treatment influence respiratory pause development, indicating it
Area of Science:
- Neonatal physiology
- Respiratory control in infants
Background:
- Preterm infants often experience respiratory pauses and apnea.
- Understanding the developmental patterns of these events is crucial for clinical management.
Purpose of the Study:
- To examine the development of pathologic apnea, respiratory pauses, and periodic respiration in high-risk preterm infants.
- To identify factors influencing the developmental trajectories of apnea variables.
Main Methods:
- Weekly observation of 71 high-risk preterm infants.
- Respiration recorded every 10 seconds, with apnea length and periodic respiration scored.
- Analysis of respiratory patterns in relation to sleep states (active and quiet).
Main Results:
- All infants exhibited respiratory pauses; 36 had pathologic apnea.
- Respiratory pause length was greater in quiet sleep, while frequency was higher in active sleep.
- Apnea length and probability decreased with age, influenced by sex, theophylline, race, and ventilation duration.
Conclusions:
- Apnea in preterm infants is not a single, uniform condition.
- Developmental trajectories of respiratory pauses and apnea are influenced by multiple factors and change with age.
Abstract:
The development of pathologic apnea, respiratory pauses, and periodic respiration was examined in 71 high-risk preterm infants, observed weekly. Respiration was recorded every 10 seconds; apnea length and periodic respiration were scored from a tape. All subjects had respiratory pauses, and 36 had pathologic apnea. The mean length of respiratory pauses was longer in quiet sleep, and the frequency of respiratory pauses was greater in active sleep. The mean length of respiratory pauses and probability of pathologic apnea in both sleep states and frequency of pauses in quiet sleep decreased with age. Sex, theophylline treatment, race, and length of mechanical ventilation affected the developmental trajectories of some apnea variables. Apnea in preterm infants cannot be considered a unitary phenomenon.