Mixed and Obstructive Sleep Apnea and Near Miss for Sudden Infant Death Syndrome: 2. Comparison of Near Miss and Normal Control Infants by Age

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 882-891 ◽  
Author(s):  
Christian Guilleminault ◽  
Ronald Ariagno ◽  
Rowena Korobkin ◽  
Lynn Nagel ◽  
Roger Baldwin ◽  
...  
Keyword(s):  
Normal Control ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Obstructive Apnea ◽  
Respiratory Events ◽  
Obstructive Sleep

Twenty-nine full-term near miss for sudden infant death syndrome (SIDS) and 30 normal control infants underwent 24-hour polygraphic monitoring. Several types of respiratory events during sleep (eg, central, mixed, and obstructive apnea, periodic breathing) were defined and tabulated. Analysis of these respiratory variables and comparison of groups of near miss and control infants indicated that between 3 weeks and 4½ months of age only one variable was consistently different at a statistically significant level: the number of mixed and obstructive apnea 3 seconds during total sleep time. This study also showed an increase in mixed and obstructive respiratory events during sleep at 6 weeks of age in control as well as in near miss infants.

The Uvula and Sudden Infant Death Syndrome

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 319-320
Author(s):  
CHRISTIAN GUILLEMINAULT
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sleep Apnea Syndrome ◽  
Sudden Infant Death ◽  
Term Infant ◽  
Near Miss ◽  
Sudden Infant ◽  
Obstructive Sleep

In Reply.— Harpey and Renault postulate a relationship between the uvula, obstructive sleep apnea, and sudden infant death syndrome. Although I believe that obstructive sleep apnea syndrome may be one of the mechanisms leading to sudden infant death syndrome, this speculation is extremely controversial. I do concur with Harpey and Renault that obstructive sleep apnea can trigger esophageal reflux. A segment from a sleep recording of a 9-week-old, full-term infant with near-miss sudden infant death syndrome is presented in the Figure.

Incidence of Apnea in Siblings of Sudden Infant Death Syndrome Victims Studied at Home

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 128-131
Author(s):  
Dorothy H. Kelly ◽  
Joseph Twanmoh ◽  
Daniel C. Shannon
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Chronic Hypoxia ◽  
Breathing Pattern ◽  
Respiratory Control ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Sibling Group

Victims of sudden infant death syndrome (SIDS) have been shown to have pathologic abnormalities consistent with chronic hypoxia.1-7 Two groups of infants at high risk of dying of SIDS, near miss infants and subsequent siblings of SIDS victims, have been studied in attempts to demonstrate physiologic abnormalities that could account for these pathologic findings. Investigators have found abnormalities in breathing pattern and the respiratory control system in the former consisting of prolonged sleep apnea, excessive short apnea, periodic breathing, hypoventilation, and depressed response to hypercarbia.8-13 However, studies in the SIDS sibling group have demonstrated varying results of excessive periodic breathing in the home14 and decreased apnea in the laboratory.15

Sleep Parameters and Respiratory Variables in ‘Near Miss’ Sudden Infant Death Syndrome Infants

PEDIATRICS ◽  
1981 ◽  
Vol 68 (3) ◽  
pp. 354-360
Author(s):  
Christian Guilleminault ◽  
Ronald Ariagno ◽  
Rowena Korobkin ◽  
Susan Coons ◽  
Margaret Owen-Boeddiker ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sleep Onset ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Normal Infant ◽  
Respiratory Events ◽  
Increased Risk ◽  
Sleep Parameters

Twenty-nine near miss for sudden infant death syndrome and thirty normal infants between the ages of 3 weeks and 6 months were monitored polygraphically for 24 hours. The distribution of sleep and abnormal respiratory events were analyzed for both groups. On the basis of mixed and obstructive apnea, 12-hour nocturnal segments (8 pm to 8 am) consistently distinguished near miss from normal infant groups between the ages of 3 weeks and 4.5 months. Daytime naps do not provide statistical differences sufficient to differentiate between the two groups. During sleep, abnormal respiratory events are more likely to occur between 1 am and 6 am, at least 40 minutes after sleep onset. Respiratory pauses show a significant increase just prior to waking (a strong respiratory stimulus). Any impairment of the arousal threshold during sleep will place near miss infants at increased risk.

Periodic Breathing in Infants With Near-Miss Sudden Infant Death Syndrome

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 355-360
Author(s):  
Dorothy H. Kelly ◽  
Daniel C. Shannon
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Average Duration ◽  
Periodic Breathing ◽  
Sleep Time ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Significant Difference ◽  
Time Average

Twelve-hour nocturnal home recordings of respiration and heart rates were obtained during sleep in 32 infants with near-miss sudden infant death syndrome (SIDS) and in 32 control infants, and the recordings were analyzed for periodic breathing. An episode of periodic breathing was defined as three or more apneic pauses of three or more seconds. The duration of respirations interrupting the pauses was 20 seconds or less. Analysis revealed a statistically significant difference (P < .001) between the two groups, using criteria of percent of periodic breathing episodes, number of periodic breathing episodes/100 min of recorded sleep time, average duration of all episodes, and duration of the longest episode of periodic breathiflg. It is concluded that periodic breathing is present in excessive amounts during sleep in infants with near-miss sudden infant death svndrome.

Effects of Obstructive Sleep Apneas on Transcutaneous Oxygen Pressure in Control Infants, Siblings of Sudden Infant Death Syndrome Victims, and Near Miss Infants: Comparison with the Effects of Central Sleep Apneas

PEDIATRICS ◽  
1982 ◽  
Vol 70 (6) ◽  
pp. 852-857
Author(s):  
Andre Kahn ◽  
Denise Blum ◽  
P. Waterschoot ◽  
E. Engelman ◽  
P. Smets
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Transcutaneous Oxygen ◽  
Obstructive Sleep ◽  
Central Apneas ◽  
Transcutaneous Po2 ◽  
Obstructive Sleep Apneas

In order to investigate the effects of obstructive sleep apneas upon transcutaneous Po2 75 polysomnograms, recorded during night sessions in 25 control infants, 25 siblings, and 25 near miss for sudden infant death syndrome (SIDS) infants were studied. These observations were compared with the decreases in transcutaneous Po2 measured during central sleep apneas in the same infants. During a total of 707.6 hours of sleep, 33 obstructive apneas and 1,650 central apneas were recorded. Obstructive apneas were seen in three control infants (three episodes), one sibling (five episodes), and six near miss for SIDS infants (25 episodes). The obstructive apneas tended to be short (less than 10 seconds). Comparatively, the central apneas were equally distributed in the three groups of infants, and only the near miss children presented apneas that lasted as long as 19 seconds. The decrease in transcutaneous Po2 was proportional to the duration of both types of apnea, but for a given duration the decrease in transcutaneous Po2 was significantly greater for the obstructive apneas than for the central apneas (with a mean difference of 7.59 ± 0.53% Po2. It is concluded that the hypoxic effects of the obstructive apneas might have important clinical implications in infants, such as the near miss for SIDS.

Respiratory Behavior in Near-Miss Sudden Infant Death Syndrome

PEDIATRICS ◽  
1982 ◽  
Vol 69 (6) ◽  
pp. 785-792
Author(s):  
Joan E. Hodgman ◽  
Toke Hoppenbrouwers ◽  
Susan Geidel ◽  
Anthony Hadeed ◽  
Maurice B. Sterman ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Sleep State ◽  
Apnea Duration ◽  
Prolonged Apnea ◽  
Respiratory Variables

Seventeen infants with unexplained prolonged apnea that has been designated near-miss sudden infant death syndrome were monitored for sleep and cardiorespiratory variables during a 12-hour, all-night recording session. Infants were matched for gestational age, sex, and age at recording with control infants. Respiratory variables studied included respiratory rate, respiratory variability, apnea duration, apnea density, and periodic breathing. No statistically significant differences were found in sleep state or respiratory variables between near-miss and control infants. Eight infants (47%) had no recurrence of prolonged apnea, whereas three (17.6%) had recurrent apneic episodes for six weeks to eight months following the original episode. No clinical or polygraphic finding predicted which infant would exhibit recurrent apnea. None of the infants was monitored at home. All infants were developing normally when examined at 1 to 2 years of age.

Episodic Complete Airway Obstruction in Infants

PEDIATRICS ◽  
1981 ◽  
Vol 67 (6) ◽  
pp. 823-827
Author(s):  
Dorothy H. Kelly ◽  
Daniel C. Shannon
Keyword(s):  
Sleep Apnea ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Central Sleep Apnea ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Obstructive Apnea ◽  
The Third ◽  
Polygraphic Recordings

Four infants with episodic silent complete obstructed apnea are described. All had central sleep apnea, three had hypoventilation, and none had obstructive apnea observed on polygraphic recordings. Two infants were siblings of a sudden infant death syndrome victim and one was a sibling of a "near miss" infant. One infant died as a result of a prolonged episode that began while she was awake. In two infants apnea has been controlled with theophylline administration and in the third infant resolution of the episode was temporally related to atropine administration.

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