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[Distribution of respiratory arrests in preterm and term infants (author's transl)]
Insights
Respiratory arrests are more common in infants during active sleep and decrease with age. Longer respiratory arrest durations occur during quiet sleep, suggesting these factors are crucial for assessing infant apnea risk.
Area of Science:
- Neonatal physiology
- Pediatric respiratory medicine
- Sleep science
Context:
- Infant respiratory arrests pose a risk, necessitating understanding of their incidence and influencing factors.
- Polygraphic recordings are essential for detailed analysis of infant cardiorespiratory events during sleep.
Purpose:
- To investigate the incidence, distribution, and periodicity of respiratory arrests in infants.
- To correlate respiratory arrest characteristics with infant age and sleep states (active vs. quiet sleep).
Summary:
- Respiratory arrests were more frequent during active sleep across all ages and decreased with increasing age.
- Longer respiratory arrest durations were observed during quiet sleep.
- Periodic breathing, prolonged apneas (>10s), and coinciding cardiac slowing were rare; abnormal findings included bradypnea and poor sleep-state differentiation of breathing patterns.
Impact:
- Findings provide critical data for evaluating the risk of severe apnea in infants.
- Establishes normative data for respiratory events in relation to sleep states and age.
- Highlights the importance of sleep state in respiratory control and apnea risk assessment in neonates.
Abstract:
Incidence, distribution and periodicity of respiratory arrests larger than or equal to 2 seconds duration were studied in relation to age and sleep states by means of polygraphic recording in 61 tracing of 44 preterm and term infants free of pathologic conditions known to increase the risk of respiratory arrests. Respiratory arrests at any infant's age were found to be more frequent during active sleep. Incidence of respiratory arrests decreases with age in all sleep states. At any age the average duration of respiratory arrest is longer in quiet sleep. When restrictive definition is applied periodic breathing was found to be a rare and probably an abnormal phenomenon not in connection with any particular sleep state. Apneas of longer than 10 seconds duration were observed rather seldon, as well as cardiac slowing coinciding with respiratory arrest or apnea. Bradypnea and poor differenciation of breathing pattern according to sleep states represent a rare and presumably abnormal finding. The authors feel that the elements observed should be considered in estimating the risk of severe apnea in infants.