Abstract
Introduction: Periodic breathing (PB) is considered
physiological in the neonatal period but must disappear in the first
months of life. Few data regarding PB after the neonatal period are
available. The objective of this study was to describe the clinical and
polysomnographic characteristics of infants presenting with PB after the
age of 1 month. Methods: This French multicenter retrospective
case series included infants born at term between 2012 and 2021, without
underlying disease, and who presented during a polysomnography (PSG)
recording more than 1% of PB after 1 month of life. Results:
Overall, 10 infants were included, they underwent a PSG for brief
resolved unexplained event, desaturation, pauses in breathing, cyanosis,
and/or signs of respiratory distress. The percentage of total sleep time
spent with PB was 18.1% before 3 months (n=7), 4.7% between 3 and 6
months (n=10), 7.1% between 7 and 12 months (n=2), and 0% after 12
months (n=2). During the first PSG, ≥ 3% desaturations were observed in
77% to 100% of the PB episodes. At the first PSG, 9/10 infants had an
obstructive apnea hypopnea index > 10/h and 5/10 had a
central apnea index > 5/h. Gastro-esophageal reflux (GER)
was suspected in 8/10 infants. All infants showed improvement in initial
symptoms during the first year of life. Conclusion: Although PB
is rare after 1 month of age, the present study shows that when present,
PB is most frequently associated with obstructive and/or central apnea
syndrome in term infants without comorbidities other than GER.