Cardiorespiratory Monitoring Data during Sleep in One-year-old Healthy Canadian Infants

Kevin Vézina, Jennifer Mariasine, Rochelle Young, Myrtha Reyna, Zihang Lu, Padmaja Subbarao, Theo J Moraes, Allan B Becker, Stuart E Turvey, Malcolm R Sears, Diana L Lefebvre, Meghan B Azad, Carmen Rasmussen, Jacqueline Pei, Indra Narang, Piush J Mandhane
Annals of the American Thoracic Society 2020 July 17

RATIONALE: Sleep study interpretation in children needs to be based on age-specific normal values. While several studies have reported normal cardiorespiratory parameters during sleep in children and adolescents, few have included younger children.

OBJECTIVES: To describe cardiopulmonary indices specifically oxygen saturation, heart rate, as well as frequency of obstructive and central apneas in healthy one-year-old Canadian infants during sleep.

METHODS: Home sleep cardiorespiratory monitoring (HSCM) was performed among infants participating in the Edmonton sub-cohort of the Canadian Healthy Infant Longitudinal Development (CHILD) Study at their one-year follow-up visit. A portable sleep monitoring device, which included a nasal pressure cannula, an oronasal thermal airflow sensor, a pulse oximeter and respiratory inductance plethysmography belts, was used to collect sleep architecture and cardiorespiratory data during one night of monitoring in the home. Sleep scoring was done in blocks of 5 minutes using a novel pilot sleep scoring algorithm.

RESULTS: Among the 562 subjects (mean±SD age 1.1±0.2 year) who attempted HSCM, 91% provided technically acceptable data with no loss of signal preventing analysis of any parameter. Obstructive and central apneas were rare with a median obstructive apnea index (OAI) of 0.0 events/hour (10th percentile, 0.0; 90th percentile, 0.5) and a median central apnea index (CAI) of 2.5 events/hour (10th percentile, 0.6; 90th percentile, 7.1). Median oxygen saturation was 97.0% (10th percentile, 95.4; 90th percentile, 97.9). The oxygen desaturation index (ODI) was 6.7 events/hour (10th percentile, 1.4; 90th percentile, 15.8) with infants spending only 0.1% (10th percentile, 0.0; 90th percentile, 0.6) of the time with an oxygen saturation below 92%.

CONCLUSION: These results provide important reference data for healthy infants undergoing cardiorespiratory monitoring during sleep.

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