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Clinical symptoms associated with brief obstructive sleep apnea in normal infants
A Kahn1, J Groswasser, M Sottiaux
1Pediatric Sleep Unit, University Children's Hospital, Free University of Brussels, Belgium.
Insights
Infants with obstructive sleep apnea often show daytime fatigue and sleep sweating. Noisy breathing during sleep is a key indicator, helping identify this condition in infants.
Area of Science:
- Pediatrics
- Sleep Medicine
- Neonatology
Background:
- Obstructive sleep apnea (OSA) in infants is understudied.
- Limited data exists on OSA manifestations in healthy infants.
Purpose of the Study:
- To identify clinical signs differentiating infants with and without obstructive sleep apnea.
- To evaluate the predictive value of identified symptoms for OSA in infants.
Main Methods:
- Parental questionnaires on infant sleep and daytime habits.
- Night monitoring polysomnography for 4,100 healthy infants.
- Matched case-control study comparing infants with (n=100) and without (n=300) OSA.
Main Results:
- Infants with OSA showed more breathholding spells, feeding fatigue, sweating, snoring, and noisy breathing.
- Profuse sweating during sleep and noisy breathing were significant independent predictors of OSA.
- These two symptoms correctly classified 89.67% of infants with OSA in a validation group.
Conclusions:
- Noisy breathing and sweating during sleep are significant indicators of obstructive sleep apnea in infants.
- These symptoms can aid in identifying infants who may require further sleep studies.
- Further research is needed to fully understand the long-term implications of OSA in infants.
Abstract:
Relatively little data exist concerning the manifestations of repeated obstructive sleep apnea in normal infants. A questionnaire concerning daytime and sleep habits was completed by the parents of 4,100 healthy infants before they underwent a 9-hour night monitoring study. One hundred infants with an obstructive apnea index above 1.2 were randomly selected. They formed the "apnea" group. From the initial population, 300 infants with no apnea were also selected to form the "no-apnea" group. Both groups were matched for sex, gestational age, post conceptional age, birth weight, mother's age, parity and a family history of sudden infant death. Five variables from the questionnaires significantly differentiated the two groups of infants. When awake, the infants with apnea were characterized by a greater frequency of breathholding spells (22% of apnea infants) and episodes of fatigue during feeding (28%) than the non-apnea infants. During sleep, they exhibited a greater frequency of profuse sweating (15%), snoring (26%) or noisy breathing (44%). Multiple symptoms were present in some infants. A stepwise logistic regression resulted in two significant independent variables: profuse sweating during sleep (p = 0.008) and noisy breathing (p = 0.002). The predictive value of these two symptoms was tested on a new group of 650 healthy infants. The two independent variables led to the correct classification of 60 of the 67 infants with apnea (89.67%) and 382 of the 583 non-apnea infants (65.5%). A positive history alone had a positive predictive value of 0.21.(ABSTRACT TRUNCATED AT 250 WORDS)