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.

Effects of Central Apneas on Transcutaneous Po2 in Control Subjects, Siblings of Victims of Sudden Infant Death Syndrome, and Near Miss Infants

PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 413-418
Author(s):  
A. Kahn ◽  
D. Blum ◽  
E. Engelman ◽  
P. Waterschoot
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Quiet Sleep ◽  
Transcutaneous Oxygen ◽  
Control Subjects ◽  
Transcutaneous Oxygen Pressure ◽  
Central Apneas

A total of 75 polysomnograms recorded during night sessions in 25 control subjects, 25 siblings of sudden infant death syndrome victims, and 25 near miss infants were studied in order to correlate the duration of central apnea to the decrease in transcutaneous oxygen pressure (tcPo2). A total of 1,650 central apneas were recorded. The three groups of infants presented the same tendency for a lower tcPo2 in indeterminate and active sleep as in quiet sleep (P > .10). The apneas were not preceded by a decrease in tcPo2, but were followed by a decrease in tcPo2, directly proportional to the duration of apnea. The correlation was measured in each infant individually, and proved to be significant in all cases, and comparable in the three groups. The longest apneas (greater than ten seconds) were followed by the greatest decrease in tcPo2, and were restricted to the near miss group. Apart from this observation, the near miss and sibling infants did not show lower tcPo2 than the control subjects, at any time, during sleep.

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.

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.

Arousal responses in near-miss sudden infant death syndrome and in normal infants

1982 ◽  
Vol 101 (6) ◽  
pp. 911-917 ◽  
Author(s):  
Kristine McCulloch ◽  
Robert T. Brouillette ◽  
Anthony J. Guzzetta ◽  
Carl E. Hunt
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant

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

`Near-Miss' for Sudden Infant Death Syndrome Infants: A Clinical Problem

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 726-730
Author(s):  
Ronald L. Ariagno ◽  
Christian Guilleminault ◽  
Rowena Korobkin ◽  
Margaret Owen-Boeddiker ◽  
Roger Baldwin
Keyword(s):  
Preterm Infants ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Specific Treatment ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Term Infants ◽  
Medical Evaluation

Three hundred six infants were referred for evaluation of "near-miss" sudden infant death syndrome (SIDS) from 1973 to 1980. Following the hospitalization and medical evaluation, there were 156 infants (115 term and 41 preterm) for whom there was no explanation for the presenting event and who were considered near-miss infants; 88% of these infants were seen during the first 3 months of life. A repeat near-miss event was reported in 63% (term) and 83% (preterm) infants. Twelve percent of term infants and 17% of the preterm infants had ten or more repeat events. A home apnea/cardiac monitor was prescribed for 88% of the infants for an average duration of 5.6 months in term infants and 3.5 months in preterm infants. Monitoring had been discontinued in 69% of the infants by 7 months of age. One full-term infant was later a SIDS victim. The risk of a repeat nearmiss event is concluded to be sufficiently great to demand immediate hospitalization, medical evaluation, home monitoring when there is no specific treatment, and close clinical follow-up. Follow-up studies are needed to determine whether there is any long-term morbidity for infants who have had near miss events.

Cerebrospinal Fluid and Plasma Beta-Endorphin Concentrations in Prolonged Infant Apnea (Near-Miss Sudden Infant Death Syndrome)

1986 ◽  
Vol 9 (4) ◽  
pp. 224-230 ◽  
Author(s):  
Koravangattu Sankaran ◽  
Kenneth Wayne Hindmarsh ◽  
Sylvia Mary Wallace ◽  
Rhonda Jane McKay ◽  
Maureen O’Donnell
Keyword(s):  
Cerebrospinal Fluid ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Beta Endorphin
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