• The Journal of pediatrics · Mar 2020

    Observational Study

    Clinically Asymptomatic Sleep-Disordered Breathing in Infants with Single-Ventricle Physiology.

    • Robyn W Stamm, Brandon M Henry, Hemant Sawnani, Narong Simakajornboon, Geoffrey Rulong, Nicholas J Ollberding, Samuel P Hanke, Thomas J Dye, and David S Cooper.
    • College of Nursing, University of Cincinnati, Cincinnati, OH; Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: Robyn.stamm@uc.edu.
    • J. Pediatr. 2020 Mar 1; 218: 92-97.

    ObjectivesTo assess clinically asymptomatic infants with single-ventricle physiology (SVP) for sleep-disordered breathing (SDB) in the supine and car seat positions using polysomnography. Polysomnography results also were compared with results of a standard Car Seat Challenge to measure the dependability of the standard Car Seat Challenge.Study DesignThis was an observational study of 15 infants with SVP. Polysomnography data included Obstructive Index, Central Index, Arousal Index, Apnea Hypopnea Index, and sleep efficiency. Polysomnography heart rate and oxygen saturation data were used to compare polysomnography with the standard Car Seat Challenge.ResultsPolysomnography demonstrated that all 15 infants had SDB and 14 had obstructive sleep apnea (Obstructive Index ≥1/hour) in both the supine and car seat positions. Infants with SVP had a statistically significant greater median Obstructive Index in the car seat compared with supine position (6.3 vs 4.2; P = .03), and median spontaneous Arousal Index was greater in the supine position compared with the car seat (20.4 vs 15.2; P = .01). Comparison of polysomnography to standard Car Seat Challenge results demonstrated 5 of 15 (33%) of infants with SVP with abnormal Obstructive Index by polysomnography would have passed a standard Car Seat Challenge.ConclusionsInfants with SVP without clinical symptoms of SDB may be at high risk for SDB that appears worse in the car seat position. The standard Car Seat Challenge is not dependable in the identification of infants with SVP and SDB. Further studies are warranted to further delineate its potential impact of SDB on the clinical outcomes of infants with SVP.Copyright © 2019 Elsevier Inc. All rights reserved.

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