Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana.
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
J Clin Sleep Med. 2019 Mar 15;15(3):437-443. doi: 10.5664/jcsm.7670.
Polysomnography (PSG) is increasingly used in the assessment of infants. Newborn PSG reference values based on recent standardization are not available. This study provides reference values for PSG variables in healthy newborn infants.
Cross-sectional study of normal term newborn infants using standardized PSG collection and American Academy of Sleep Medicine interpretation criteria.
Thirty infants born between 37 and 42 weeks gestation underwent PSG testing before 30 days of age (mean 19.6 days). The infants had a mean sleep efficiency of 71% with average proportions of transitional, NREM and REM sleep estimated at 16.1%, 43.3% and 40.6% respectively. Mean arousal index was 14.7 events/h with respiratory arousal index of 1.2 events/h. Mean apnea-hypopnea index (AHI) was 14.9 events/h. Central, obstructive, and mixed apnea indices were 5.4, 2.3, and 1.2 events/h respectively. Mean oxygen saturation in sleep was 97.9% with a nadir of 84.4%. Mean end tidal CO was 35.4 mmHg with an average of 6.2% of sleep time spent above end-tidal CO 45 mmHg and 0.6% above 50 mmHg.
The sleep efficiency was significantly lower and the AHI was significantly higher compared to healthy children older than 1 year. The AHI was also higher than reported in healthy infants older than 1 month. These findings suggest current severity classifications of sleep apnea may not apply to newborn infants.
多导睡眠图（PSG）在婴儿评估中的应用日益增多。目前尚无基于最新标准化的新生儿 PSG 参考值。本研究旨在为健康新生儿的 PSG 变量提供参考值。
采用标准化 PSG 采集和美国睡眠医学学会（AASM）解读标准对正常足月新生儿进行横断面研究。
37 至 42 周龄的 30 名新生儿在出生后 30 天内（平均 19.6 天）接受 PSG 测试。婴儿的平均睡眠效率为 71%，平均过渡性、非快速眼动（NREM）和快速眼动（REM）睡眠时间分别为 16.1%、43.3%和 40.6%。平均觉醒指数为 14.7 次/小时，呼吸觉醒指数为 1.2 次/小时。平均呼吸暂停-低通气指数（AHI）为 14.9 次/小时。中枢性、阻塞性和混合性呼吸暂停指数分别为 5.4、2.3 和 1.2 次/小时。睡眠时平均氧饱和度为 97.9%，最低值为 84.4%。平均潮气末 CO 为 35.4mmHg，有 6.2%的睡眠时间潮气末 CO 超过 45mmHg，0.6%的睡眠时间潮气末 CO 超过 50mmHg。
与 1 岁以上健康儿童相比，本研究中新生儿的睡眠效率明显较低，AHI 明显较高。与 1 个月以上健康婴儿相比，AHI 也较高。这些发现表明，目前的睡眠呼吸暂停严重程度分类可能不适用于新生儿。
