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- A respiratory pattern consisting of regular oscillations in breathing amplitude
- Typically, a respiratory pattern in which ≥3 apneas lasting ≥3 seconds occur, separated by <20 seconds of respiration
Don’t confuse periodic breathing with obstructive and/or central apnea.
- Usually absent in the first 48 hours of life
- More frequent during rapid eye movement (REM or active) sleep versus non-REM (quiet) sleep
- Less common in prone versus supine position
- In full-term infants
- Amount of periodic breathing usually <4% of total sleep time
- Amount gradually decreases through the 1st year of life.
- By 1 year of age, the mean amount of periodic breathing is <1% of total sleep time.
- In premature infants
- Amount of periodic breathing is higher than in full-term infants.
- Amount correlates inversely with gestational age.
- No common pathologic finding
- Abnormalities, when they exist, are related to the underlying disorder causing the periodic breathing.
- Periodic breathing can be seen in healthy infants, children, and adults.
- Abnormalities, in any component of the breathing control system, may result in an increased amount of periodic breathing.
- Possible etiologies
- A delay in detecting changes in blood gas values by the chemoreceptors
- Increased chemoreceptor gain
Commonly Associated Conditions
- Periodic breathing in infants is associated with the following:
- Apnea of prematurity or infancy
- Familial history of sudden infant death syndrome (SIDS)
- Anemia of prematurity
- Hypochloremic alkalosis
- Periodic breathing with adults is associated with the following:
- Cardiac abnormalities (especially congestive heart failure [CHF])
- Neurologic dysfunction (meningitis, encephalitis, brainstem dysfunction)
- Exposure to high altitudes