Correlation between phenotype and polysomnography findings of sleep-disordered breathing in term, non-syndromic infants: a case series study
- 1Division of Pediatric Pulmonology and Sleep Medicine, University of Texas Southwestern, Children's Health , , ,
Abstract
Sleep-disordered breathing (SBD) is understudied in non-syndromic term infants since most of the research focuses on high-risk groups such as premature infants or those with underlying medical conditions. There is a gap in our understanding of phenotypes that predispose this population to experience SDB. Threshold for diagnosis remain poorly standardized, and there is limited data on effective treatment strategies.
Objective: To characterize the clinical presentation and polysomnographic features of term, non-syndromic, infants referred for evaluation of suspected sleep-disordered breathing (SDB).
Methods: This was a single-center case series of review of polysomnographic (PSG) data in non-syndromic term infants from 0–12 months of age from a tertiary care center.
Results: Fifteen infants met inclusion criteria. The mean gestational age was 38.4 ± 0.6 weeks; 80% were male. The mean age at initial PSG was 7.5 ± 3.6 months. Snoring was present in 33% and 47% carried a diagnosis of gastroesophageal reflux (GER). The average apnea-hypopnea index (AHI) was 23.1/h. The mean obstructive AHI (OAHI) was 20/h and the mean central apnea index (CAI) was 3.1/h. Mean oxygen saturation was 97.5 ± 1.5%, with a nadir of 81.0 ± 9.9%. Six patients met criteria for sleep-related hypoxemia (SpO2 < 90% for ≥ 5 min). Mean and peak CO2 levels were 35 mmHg and 48.6 mmHg, respectively. None of the patients met criteria for sleep-related hypoventilation (CO2 > 50 mmHg for > 25% of total sleep time). 71% of the infants underwent an evaluation of their upper airway, and 7 had abnormal findings. Follow-up PSG obtained around 13.4 months, on average, in 10 of the infants showed resolution of SDB in 4 infants. One patient showed resolution of the SDB with CPAP, but was lost to follow-up. SDB was persistent but improved in 5 infants. AHI showed a weak negative correlation with age (ρ = −0.31, p = 0.26).
Conclusion: Frequency of moderate-severe obstructive sleep apnea (OSA) is high among non-syndromic term infants. The clinical implication of this is still unclear. However, AHI does appear to decrease with age, and many infants are able to outgrow their OSA without any intervention. Further research is warranted to refine diagnostic thresholds and standardize the diagnostic evaluation and interventions for SDB in this unique population.
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BibTeX
@article{lezama2026correlation,
title = {{Correlation between phenotype and polysomnography findings of sleep-disordered breathing in term, non-syndromic infants: a case series study}},
author = {Liz Lezama and Elisa Basora-Rovira and Aarti Shakkottai},
journal = {Frontiers in sleep},
year = {2026},
month = oct,
doi = {10.3389/frsle.2026.1877709},
url = {https://europepmc.org/article/PMC/PMC13724371},
note = {CC BY},
}
RIS
TY - JOUR
TI - Correlation between phenotype and polysomnography findings of sleep-disordered breathing in term, non-syndromic infants: a case series study
AU - Liz Lezama
AU - Elisa Basora-Rovira
AU - Aarti Shakkottai
PY - 2026
DA - 2026/10/19
JO - Frontiers in sleep
DO - 10.3389/frsle.2026.1877709
UR - https://europepmc.org/article/PMC/PMC13724371
AB - Sleep-disordered breathing (SBD) is understudied in non-syndromic term infants since most of the research focuses on high-risk groups such as premature infants or those with underlying medical conditions. There is a gap in our understanding of phenotypes that predispose this population to experience SDB. Threshold for diagnosis remain poorly standardized, and there is limited data on effective treatment strategies. Objective: To characterize the clinical presentation and polysomnographic features of term, non-syndromic, infants referred for evaluation of suspected sleep-disordered breathing (SDB). Methods: This was a single-center case series of review of polysomnographic (PSG) data in non-syndromic term infants from 0–12 months of age from a tertiary care center. Results: Fifteen infants met inclusion criteria. The mean gestational age was 38.4 ± 0.6 weeks; 80% were male. The mean age at initial PSG was 7.5 ± 3.6 months. Snoring was present in 33% and 47% carried a diagnosis of gastroesophageal reflux (GER). The average apnea-hypopnea index (AHI) was 23.1/h. The mean obstructive AHI (OAHI) was 20/h and the mean central apnea index (CAI) was 3.1/h. Mean oxygen saturation was 97.5 ± 1.5%, with a nadir of 81.0 ± 9.9%. Six patients met criteria for sleep-related hypoxemia (SpO2 < 90% for ≥ 5 min). Mean and peak CO2 levels were 35 mmHg and 48.6 mmHg, respectively. None of the patients met criteria for sleep-related hypoventilation (CO2 > 50 mmHg for > 25% of total sleep time). 71% of the infants underwent an evaluation of their upper airway, and 7 had abnormal findings. Follow-up PSG obtained around 13.4 months, on average, in 10 of the infants showed resolution of SDB in 4 infants. One patient showed resolution of the SDB with CPAP, but was lost to follow-up. SDB was persistent but improved in 5 infants. AHI showed a weak negative correlation with age (ρ = −0.31, p = 0.26). Conclusion: Frequency of moderate-severe obstructive sleep apnea (OSA) is high among non-syndromic term infants. The clinical implication of this is still unclear. However, AHI does appear to decrease with age, and many infants are able to outgrow their OSA without any intervention. Further research is warranted to refine diagnostic thresholds and standardize the diagnostic evaluation and interventions for SDB in this unique population.
SN - 2813-2890
ER -