Zenteno Daniel, Torres-Puebla Gerardo, Sánchez Camila, Gutiérrez Rocío, Elso María José, Brockmann Pablo E
Department of Pediatrics, Faculty of Medicine, University of Concepción, Concepcion 4070409, Chile.
Mechanical Ventilation and Sleep Unit, Pediatric Service, Guillermo Grant Benavente Hospital, Concepcion 4070038, Chile.
Clocks Sleep. 2025 Aug 12;7(3):42. doi: 10.3390/clockssleep7030042.
This study described and analyzed the results of cardiorespiratory polygraphic studies in infants under three months who were hospitalized and monitored due to suspected apneas.
Cross-sectional study. Patients aged <3 months hospitalized from 2011 to 2023 were included. All were referred for suspected apneas, and cardiorespiratory polygraphies (PG) were conducted simultaneous to non-invasive monitoring. Demographic, PG, and diagnostic variables were recorded. PG values were obtained and compared between diagnostic groups. Association was evaluated according to diagnosis, prematurity, presence, and alteration type with Kruskal-Wallis, Wilcoxon, and Fisher tests. Association between quantitative variables was assessed with Spearman's rho and the presence of alteration with binomial logistic regression. Analysis was performed with Jamovi v.2.3, and statistical significance was defined as < 0.05.
A total of 155 studies were included. Median age was 41.0 days (IQR 22.0-59.0), median gestational age was 38 weeks (IQR 32.0-42.0), and 52.3% were premature.
brief resolved unexplained events (BRUE) (58.1%), apnea of prematurity (27.1%), hypotonic syndrome (7.1%), laryngomalacia (LGM) (3.9%), and craniofacial alterations (CFA) (3.9%). Altered results in 21.9% polygraphies: 44.1% with AHI ≧ 5/h and 20.6% with SpO ≦ 90% in >5% of the record. CFA and LGM patients had a higher risk of an altered polygraph than those with apnea of prematurity (OR 21.3/8.5) and BRUE (OR 35.9/14.3), respectively.
Infants under three months of age referred for apnea showed often abnormal polygraphic indices, showing significant differences between diagnostic groups. Performance of sleep studies in these groups was feasible and allowed to confirm the presence of apneas and their level of severity. Particular attention should be considered in children with CFA and LMG, since their risk is significantly higher. Age-specific apnea patterns seem to be of interest, as this may possibly lead to future consequences.
本研究描述并分析了因疑似呼吸暂停而住院监测的三个月以下婴儿的心肺多导睡眠图研究结果。
横断面研究。纳入2011年至2023年住院的年龄小于3个月的患者。所有患者均因疑似呼吸暂停转诊,并在进行无创监测的同时进行心肺多导睡眠图(PG)检查。记录人口统计学、PG和诊断变量。获取PG值并在诊断组之间进行比较。根据诊断、早产情况、是否存在以及改变类型,采用Kruskal-Wallis检验、Wilcoxon检验和Fisher检验评估相关性。使用Spearman秩相关评估定量变量之间的相关性,并使用二项逻辑回归评估改变的存在情况。使用Jamovi v.2.3进行分析,统计学显著性定义为P<0.05。
共纳入155项研究。中位年龄为41.0天(四分位间距22.0 - 59.0),中位胎龄为38周(四分位间距32.0 - 42.0),52.3%为早产儿。
短暂性不明原因事件(BRUE)(58.1%)、早产呼吸暂停(27.1%)、低渗综合征(7.1%)、喉软化症(LGM)(3.9%)和颅面畸形(CFA)(3.9%)。21.9%的多导睡眠图结果异常:44.1%的患者呼吸暂停低通气指数(AHI)≥5次/小时,20.6%的患者在记录的>5%时间内血氧饱和度(SpO)≤90%。CFA和LGM患者多导睡眠图异常的风险分别高于早产呼吸暂停患者(比值比[OR] 21.3/8.5)和BRUE患者(OR 35.9/14.3)。
因呼吸暂停转诊的三个月以下婴儿多导睡眠图指数常异常,诊断组之间存在显著差异。在这些组中进行睡眠研究是可行的,能够确认呼吸暂停的存在及其严重程度。对于CFA和LMG患儿应给予特别关注,因为他们的风险显著更高。特定年龄的呼吸暂停模式似乎值得关注,因为这可能会导致未来的后果。