Table 2.
Indication, diagnosis, and result of polysomnography in preterm infants.
| ID No. | Primary Comorbid Condition | Indication | Diagnosis | Total AHI | cAHI | oAHI | O2 Sat Nadir | Treatment | Symptoms Resolved | Description |
|---|---|---|---|---|---|---|---|---|---|---|
| 16 | Neurologic | Recurrent desaturations/suspected obstructive apnea | Hypoxic ischemic encephalopathy | 113.9 | 6.1 | 87.3 | 67.8 | None (tracheostomy recommended, declined for comfort care) | No | ex-33 week infant, 39 weeks corrected, hypoxic ischemic encephalopathy at birth. ENT evaluation reveled pooling of secretions with aspiration. Brain MRI consistent with HIE. |
| 17 | Craniofacial anomaly | Suspected obstructive apnea | RAPADILINO syndrome with micrognathia/Pierre Robin sequence | 11.9 | 1.9 | 10 | 89.1 | None | No | ex-32 week infant, 42 weeks corrected, with VACTERL syndrome, micrognathia, cleft palate and glossoptosis (Pierre Robin sequence), diagnosed with RAPADILINO syndrome. |
| 18 | Craniofacial anomaly | Suspected obstructive apnea | Micrognathia/Pierre Robin sequence | 75.2 | 1.3 | 74.2 | 65.6 | Mandibular distraction | Yes | ex-36 week infant with micrognathia and cleft palate (Pierre Robin sequence). |
| 2.9 | 0 | 2.9 | 91.5 | Follow-up Study | ||||||
| 19 | Craniofacial anomaly | Recurrent desaturations/suspected obstructive apnea | Micrognathia/Pierre Robin sequence | 144 | 67 | 76 | 80.6 | Tongue-lip adhesion | Yes | ex-35 week infant, with micrognathia and cleft palate. ENT evaluation revealed glossoptosis. |
| 23 | 6.4 | 8.9 | 85 | Follow-up study | ||||||
| 20 | Upper airway anomaly | Recurrent desaturations/stridor | Laryngomalacia | 25.2 | 11 | 14 | 59.7 | No change | No | ex-35 week infant, already on HFNC prior to PSG with symptoms improving over time. |
| 21 | Upper airway anomaly | Recurrent desaturations | Soft palate collapse/glossoptosis | 72.2 | 2.3 | 64.6 | 33.3 | Tracheostomy | Yes | ex-25 week infant, 40 weeks corrected with recurrent desaturation episodes requiring HFNC. ENT evaluation revealed soft palate collapse and glossoptosis. |
| 22 | Respiratory | Recurrent desaturations | Apnea of prematurity | 6.7 | 1.1 | 4.5 | 89.9 | O2 via NC | Yes | ex-31 week infant, 46 weeks corrected, with recurrent desaturation and bradycardic events associated with apnea of prematurity. |
| 23 | Respiratory | Recurrent desaturations | Apnea of prematurity | 7.6 | 1.3 | 6.3 | 89 | HFNC | Yes | ex-30 week infant, 44 weeks corrected, with recurrent desaturation and bradycardic events associated with apnea of prematurity. |
| 24 | Respiratory | Recurrent desaturations | Apnea of prematurity | 31.4 | 24 | 7.3 | 63 | Caffeine | No | ex-29 wk infant, 39 weeks corrected, with recurrent desaturation and bradycardic events associated with apnea of prematurity. |
| 13.4 | 12.6 | 0.9 | 77.8 | Caffeine dose increased | Yes | Follow-up study | ||||
| 25 | Respiratory | Recurrent desaturations | Apnea of prematurity | 11.9 | 9 | 2.5 | 80.5 | None | Yes | ex-29 6/7 week infant, 40 weeks corrected, with recurrent desaturation and bradycardic events associated with apnea of prematurity. |
| 26 | Respiratory | Recurrent desaturations | Apnea of prematurity | 8 | 2 | 6 | 82 | Prevacid/Alimentum | Yes | ex-27 week infant, 43 weeks corrected, with recurrent desaturations and bradycardic events associated with apnea of prematurity. Results of PSG interpretation, not classically OSA, occurring with movements possibly related to GERD contributing to apneic events. |
| 27 | Respiratory | Recurrent desaturations | Apnea of prematurity/feeding immaturity | 6.7 | 1.1 | 4.5 | 89.9 | No change | Yes | ex-31 week infant, 41 weeks corrected with recurrent desaturations and bradycardic events associated with apnea of prematurity and feeding immaturity. MBS showed aspiration, thickening of feeds did not resolve events. O2 via NC started prior to PSG, with PSG confirming improvement in events with NC. |
| 28 | Respiratory | Recurrent desaturations | Apnea of prematurity/feeding immaturity | 39.8 | - | - | 72.6 | Caffeine | Yes | ex-32 wk, 40 weeks corrected, with recurrent desaturations and bradycardic events associated with apnea of prematurity and feeding immaturity. Discharged home on caffeine. |
| 7.1 | 6.5 | 0.6 | 79.1 | Follow-up study | ||||||
| 29 | Respiratory | Suspected obstructive apnea | Chronic lung disease | 16 | 13.9 | 2 | 73.3 | Caffeine | Yes | ex-33 week infant, 42 weeks corrected, with persistent tachypnea on O2 via NC. |
| 4.2 | 3.8 | 0.4 | 91.2 | Follow-up study | ||||||
| 30 | Respiratory | Suspected obstructive apnea | Chronic lung disease/bronchomalacia/CPAM | 28.5 | 0 | 28.5 | 85 | Tracheostomy | No | ex-33 week infant, 45 weeks corrected with VACTERL syndrome, CPAM, congenital hypothyroidism and persistent tachypnea requiring HFNC. ENT evaluation revealed soft palate cleft, edema of arytenoids and bronchomalacia. |
| 31 | Respiratory | Suspected obstructive apnea | Chronic lung disease/pulmonary hypertension | 11.1 | 5 | 5 | 77.4 | No change | No | ex-24wk infant, 2 months corrected, with severe chronic lung disease, pulmonary hypertension and hypercarbia requiring persistent HFNC. |
Bold numbers represent the predominant component of AHI. AHI = apnea-hypopnea index, cAHI = central AHI, CPAM = congenital pulmonary airway malformation, ENT = ear, nose, and throat, GERD = gastroesophageal reflux disease, HFNC = high-flow nasal cannula, HIE = hypoxic ischemic encephalopathy, MBS = modified barium swallow, NC = nasal cannula, oAHI = obstructive AHI, OSA = obstructive sleep apnea, PSG = polysomnography; RAPADILINO = radial malformations, patella and palate abnormalities, diarrhea, dislocated joints, limb abnormalities, little size long, slender nose and normal intelligence; VACTERL = vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities.