Periodic Breathing in Infants

Definition and Prevalence

• Periodic breathing is defined as ≥3 episodes of central apnea lasting >3 seconds separated by no more than 20 seconds of normal breathing, according to the American Academy of Sleep Medicine 1, 2, 3

Age-Related Changes

• The time spent with paradoxical inward rib cage movement during REM sleep decreases with age, present during nearly 100% of REM sleep time in newborns and only 10% of REM sleep time by 3 years of age, as reported by the American Journal of Respiratory and Critical Care Medicine 4, 5

Clinical Significance and Monitoring

• The normal respiratory pattern and oxygenation status of infants in the 2-8 month at-risk age range for SIDS is still not fully understood, as noted by the American Journal of Respiratory and Critical Care Medicine 6, 7
• Routine polysomnography in infants presenting with lower-risk BRUE is likely to have low diagnostic yield and unlikely to lead to changes in therapy, according to the American Academy of Pediatrics 8