The incidence of obstructive apneas in preterm infants with and without bronchopulmonary dysplasia

Fajardo, Carlos; Alvarez, Jorge; Wong, Anita; Kwiatkowski, Kim; Rigatto, Henrique

doi:10.1016/0378-3782(93)90012-j

Cited by 27 publications

(18 citation statements)

References 14 publications

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“…Furthermore, among the 9 of 12 infants with OSA who had BPD, the severity of BPD was not correlated with severity of the OSA. Similar findings have been previously reported, whereby the presence of BPD has not effect on the frequency of obstructive respiratory events during sleep (Fajardo et al, 1993). However, we should emphasize that this is a descriptive study in a small cohort of patients, and that causal inferences will have to await larger future studies.…”

Section: Discussionsupporting

confidence: 91%

Obstructive Sleep Apnea in the Formerly Preterm Infant: An Overlooked Diagnosis

Sharma¹,

Baroody²,

Gozal³

et al. 2011

Front. Neur.

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Background: Obstructive sleep apnea syndrome (OSA) is a frequent disorder in children. The clinical characteristics of OSA in very young children under 2 years of age, and more particularly, in those born prematurely, and who have respiratory complications such as bronchopulmonary dysplasia (BPD), are not well defined. We therefore retrospectively reviewed our experience in a group of preterm infants with OSAS. Methods: The records of premature infants with BPD followed in the Pediatric Pulmonary Clinic at the University of Chicago who were diagnosed with OSA from 2004 to 2009 were reviewed and analyzed. Results: Twelve children, eight males, and four females with a mean gestational age of 27 weeks were found to have OSA. Mean age at diagnosis was 19 months. Inability to wean nighttime oxygen, the need to resume oxygen after intercurrent respiratory illness, and snoring were the most common presenting symptoms. The apnea–hypopnea index ranged from 1 to 120/h total sleep time (TST; mean: 29). SpO2 nadir ranged from 50 to 91%. Despite adenotonsillectomy (AT), all children had persistent sleep disordered breathing. Conclusion: In preterm infants, while snoring is a frequent symptom, poor weight gain, and inability to wean nighttime oxygen may indicate the need for further investigation for OSA. In the former preterm infant structural changes in the airway may play an important role along with adenotonsillar hypertrophy. A high level of clinical awareness is required to identify OSA in the formerly preterm infant.

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Section: Discussionsupporting

confidence: 91%

Obstructive Sleep Apnea in the Formerly Preterm Infant: An Overlooked Diagnosis

Sharma¹,

Baroody²,

Gozal³

et al. 2011

Front. Neur.

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“…Specifically, it has been speculated that this risk of sudden death may be related to impairments in ventilatory control that leave infants with BPD particularly vulnerable to disordered breathing during sleep, contributing to a higher risk of sudden infant death syndrome (SIDS) (Hunt et al 1981; Werthammer et al 1982; Garg et al 1988; Calder et al 1994; Katz-Salamon et al 1996). During sleep, infants with BPD experience more central and obstructive apneas than age-matched infants without BPD (Sekar and Duke 1991; Fajardo et al 1993), and the apneas occur more frequently in the prone position than supine (Hibbs et al 2008). Infants with BPD also tend to maintain a higher minute ventilation to support their oxygenation demands compared to term infants.…”

Section: Sleepmentioning

confidence: 99%

Ventilatory control in infants, children, and adults with bronchopulmonary dysplasia

Bates

Pillers

Palta

et al. 2013

Respiratory Physiology & Neurobiology

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Bronchopulmonary dysplasia (BPD), or chronic lung disease of prematurity, occurs in ~30% of preterm infants (15,000 per year) and is associated with a clinical history of mechanical ventilation and/or high inspired oxygen at birth. Here, we describe changes in ventilatory control that exist in patients with BPD, including alterations in chemoreceptor function, respiratory muscle function, and suprapontine control. Because dysfunction in ventilatory control frequently revealed when O2 supply and CO2 elimination are challenged, we provide this information in the context of four important metabolic stressors: stresses: exercise, sleep, hypoxia, and lung disease, with a primary focus on studies of human infants, children, and adults. As a secondary goal, we also identify three key areas of future research and describe the benefits and challenges of longitudinal human studies using well-defined patient cohorts.

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“…There are limited data on the prevalence of SDB in children with a history of BPD. Studies evaluating polysomnograms (PSGs) performed on infants with BPD have found a higher rate of respiratory events compared to non‐BPD infants . During sleep, there is a reduction in airway muscle activity and ventilatory effort.…”

Section: Introductionmentioning

confidence: 99%

Sleep disordered breathing in bronchopulmonary dysplasia

Ortiz

McGrath‐Morrow

Sterni

et al. 2017

Pediatric Pulmonology

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BACKGROUND There are limited data on the effect of bronchopulmonary dysplasia (BPD) on sleep disordered breathing (SDB). We hypothesized that both the severity of prematurity and BPD would increase the likelihood of SDB in early childhood. Our secondary aim was to evaluate the association of demographic factors on the development of SDB. METHODS This is a retrospective study of patient factors and overnight polysomnogram (PSG) data of children enrolled in our BPD registry between 2008 and 2015. Association between PSG results and studied variables was assessed using multiple linear regression analysis. RESULTS One-hundred-forty children underwent at least one sleep study on room air. The mean respiratory disturbance index (RDI) was elevated at 9.9 events/hr (SD: 10.1). The mean obstructive apnea-hypopnea index (OAHI) was 6.5 (9.1) events/hr and the mean central event rate of 3.0 (3.7) events/hr. RDI had decreased by 22% or 1.5 events/hour (95% CI: 0.6, 1.9) with each year of age (p=0.005). Subjects with more severe respiratory disease had 38% more central events (p=0.02). Infants exposed to secondhand smoke had 2.4% lower (p=0.04) oxygen saturation nadirs and a pattern for more desaturation events. Non-white subjects were found to have 33% higher OAHI (p=0.05), while white subjects had a 61% higher rate of central events (p<0.001). CONCLUSIONS RDI was elevated in a selected BPD population compared to norms for non-preterm children. BPD severity, smoke exposure, and race may augment the severity of SDB. RDI improved with age but was still elevated by age 4, suggesting that this population is at risk for the sequelae of SDB.

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The incidence of obstructive apneas in preterm infants with and without bronchopulmonary dysplasia

Cited by 27 publications

References 14 publications

Obstructive Sleep Apnea in the Formerly Preterm Infant: An Overlooked Diagnosis

Obstructive Sleep Apnea in the Formerly Preterm Infant: An Overlooked Diagnosis

Ventilatory control in infants, children, and adults with bronchopulmonary dysplasia

Sleep disordered breathing in bronchopulmonary dysplasia

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