Home monitoring during infancy: what is normal?

doi:10.1053/prrv.2002.0178

Paediatric Respiratory Reviews

Volume 3, Issue 1, March 2002, Pages 10-17

https://doi.org/10.1053/prrv.2002.0178 Get rights and content

Abstract

This article reviews studies on infants to obtain ‘normal’ parameters for apnoea, heart rate and O₂ saturation in healthy full-term infants. Studies have been carried out in both hospital and home settings using different protocols and these are reviewed and assessed as a means of providing baseline data for home memory monitoring of infants.

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Cited by (4)

Overnight polysomnographic characteristics and oxygen saturation of healthy infants, 1 to 18 months of age, born and residing at high altitude (2,640 meters)
2015, Chest
Citation Excerpt :
The temporal trajectory of such changes, as illustrated in Figure 1, may be related to some changes occurring in the respiratory mechanics during the first 6 months of life with a more passive maintenance of functional residual capacity and reduced compliance of the chest wall, which will stabilize lung volumes and thereby provide increased resistance to desaturation during respiratory events.47–49 In addition, postnatal developmental changes in respiratory control may further enhance the stability and robustness of the respiratory system and, thus, prevent or dampen oscillatory behaviors in respiratory patterning (eg, reduced frequency of PB).34,50,51 We should note that although less likely, we cannot exclude the possibility that the progressive attenuation of the respiratory and hypoxemic event frequencies with age could also reflect the well-known acclimatization to high-altitude hypoxia.52,53
Approximately 8% of the world population resides above 1,600 m, with about 10 million people living above 2,500 m in Colombia. However, reference values for polysomnography (PSG) and oxygen saturation (Spo₂) of children < 2 years old residing at high altitude are currently unavailable.
Healthy infants aged 1 to 18 months born and residing at high altitude (Bogotá: 2,640 m) underwent overnight PSG. Four age groups were defined: group 1, < 45 days; group 2, 3 to 4 months; group 3, 6 to 7 months; and group 4, 10 to 18 months. Of 122 children enrolled, 50 had three consecutive PSG tests and were analyzed as a longitudinal subcohort.
A total of 281 PSG tests were performed in 122 infants (56% girls): group 1, 106 PSG tests; group 2, 89 PSG tests; group 3, 61 PSG tests; and group 4, 25 PSG tests. Active sleep diminished and quiet sleep increased with maturation. Apnea-hypopnea indexes (total, central, and obstructive) were highest in group 1 (21.4, 12.4, and 6.8/h total sleep time, respectively) and diminished with age (P < .001). Mean Spo₂ during waking and sleep increased with age (P < .001). Nadir Spo₂ values during respiratory events were lower in younger infants. Longitudinal assessments of 50 infants confirmed the temporal trends described for the cross-sectional dataset.
Healthy infants (≤ 18 months old) born and residing at high altitude show preserved sleep architecture but higher apnea-hypopnea indexes and more prominent desaturation with respiratory events than do those living at low altitude. The current study findings can be used as reference values for infants at high altitude.
Normative values of polysomnographic parameters in childhood and adolescence: Cardiorespiratory parameters
2011, Sleep Medicine
Citation Excerpt :
The aim of this study was to present normative values of cardiorespiratory sleep parameters in carefully screened, healthy subjects 1–18 years of age and to characterize gender, age, and maturation dependence of cardiorespiratory parameters in sleep. Because infants have been studied extensively by others [2–4], we did not include infants younger than one year old in this study. In 2007 the American Academy of Sleep Medicine defined rules for scoring sleep related apneas in childhood [5], and the presented data enable further discussion of these new rules.
To provide normative values for pediatric sleep cardiorespiratory parameters following AASM rules, assessing effects of gender, age, and Tanner stage.
One-night polysomnograhy was performed at subjects’ habitual bedtimes in 16 laboratories on 209 healthy German children, 1–18 years old.
Normative values of cardiorespiratory parameters in pediatric sleep are presented. No obstructive and mixed apneas occurred. Hypopneas were seldom. Respiratory frequency and apnea-hypopnea-index decreased with age (p < 0.001). In all groups central apneas ⩾20 s were present but uncommon. Oxygen desaturations or respiratory arousals following central apnea were rare. Heart rate showed an inverse correlation to age (p < 0.001). Heart rate was lower in sleep, lowest in stage N. The mean heart rate of females was higher than males (p < 0.05). Neither Tanner stage nor corresponding age (p < 0.05) influenced: mean apnea duration, central apnea index ⩾20 s, hypopnea index, index of periodic breathing, or oxygen saturation nadir. All other parameters except maximal apnea duration and central apnea index after movements with oxygen desaturation show dependency on both Tanner stage and corresponding age (p < 0.05).
Using AASM rules, the development of cardiorespiratory parameters in healthy children, ages 1–18 is shown. Age-related norms may improve sleep pathology identification.
Apparent Life-Threatening Event, Infant Apnea, and Pediatric Obstructive Sleep Apnea Syndrome
2007, Comprehensive Pediatric Hospital Medicine
When norepinephrine becomes a driver of breathing irregularities: How intermittent hypoxia fundamentally alters the modulatory response of the respiratory network
2014, Journal of Neuroscience

^f1: Correspondence to: Dr Carl Hunt, Tel: +1 301 435 0199; Fax: +1 301 480 3451; E-mail: [email protected]

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Regular ArticleHome monitoring during infancy: what is normal?

Abstract

J Pediatr

J Pediatr

Comparison of apnoea identified by respiratory inductance plethysmography with that detected by end tidal CO2or thermistor

Am J Respir Crit Care Med

Respiration during the first six months of life in normal infants. III. Computer identification of breathing pauses

Pediatr Res

Episodes of bradycardia during early infancy in the term-born and preterm infant

AJDJ

Apnoea recordings of healthy infants at 40, 44, and 52 weeks postconception

Pediatrics

The frequency of apnoea and bradycardia in a population of healthy, normal infants

Neuropediatrics

Regular Article
Home monitoring during infancy: what is normal?

Comparison of apnoea identified by respiratory inductance plethysmography with that detected by end tidal CO₂or thermistor