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Arousal pattern following central and obstructive breathing abnormalities in infants and children

F McNamara1, F G Issa, C E Sullivan

  • 1National Sudden Infant Death Syndrome, Council David Read Paediatric Sleep Disorders Unit, Royal Alexandra Hospital for Children, Sydney, New South Wales, Australia.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|December 1, 1996
PubMed

Insights

Arousals rarely terminate respiratory events in pediatric obstructive sleep apnea (OSA). This suggests electroencephalographic criteria are not essential for assessing OSA severity in children and infants.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Physiology
  • Neurology

Background:

  • Obstructive sleep apnea (OSA) is common in children and infants.
  • The role of sleep arousal in terminating respiratory events in pediatric OSA is not fully understood.
  • Existing diagnostic criteria may not adequately capture OSA severity in this population.

Purpose of the Study:

  • To investigate the relationship between central and obstructive breathing abnormalities and sleep arousal in pediatric OSA.
  • To determine the frequency of arousal in terminating respiratory events in infants and children with OSA.
  • To compare spontaneous arousal frequency between OSA patients and controls.

Main Methods:

  • Analysis of polysomnographic records from 15 children and 20 infants with OSA.
  • Matching OSA patients with age-matched controls without OSA.
  • Quantification of respiratory events and associated arousals during sleep.

Main Results:

  • The majority of respiratory events in both infants and children with OSA were not terminated by arousal.
  • Arousals terminated significantly fewer events in infants (approx. 8%) compared to children (approx. 38%).
  • Respiratory-related arousals were more frequent after obstructive events than central events; spontaneous arousal patterns differed between infants with and without OSA.

Conclusions:

  • Sleep arousal is not a primary mechanism for terminating respiratory events in pediatric OSA.
  • Electroencephalographic criteria may not be essential for determining the clinical severity of OSA in infants and children.
  • Further research into alternative markers for OSA severity in pediatric populations is warranted.

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