What Are the Factors Affecting Total Sleep Time During Video Polysomnography in Infants?

Grace R. Paul; Don Hayes Jr.; Dmitry Tumin; Ish Gulati; Sudarshan Jadcherla; Mark L. Splaingard

doi:10.1055/s-0040-1718948

American Journal of Perinatology, Table of Contents

Am J Perinatol 2022; 39(08): 853-860
DOI: 10.1055/s-0040-1718948

Original Article

What Are the Factors Affecting Total Sleep Time During Video Polysomnography in Infants?

Grace R. Paul

¹Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, Columbus, Ohio

,

Don Hayes Jr.

²Department of Pediatrics, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio

,

Dmitry Tumin

³Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina

,

Ish Gulati

⁴Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio

,

Sudarshan Jadcherla

⁴Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio

,

Mark L. Splaingard

¹Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, Columbus, Ohio

› Author Affiliations

Abstract

Objective The aim of the study is to investigate factors affecting total sleep time (TST) during infant polysomnography (PSG) and assess if <4 hours of TST is sufficient for accurate interpretation.

Study Design Overall, 242 PSGs performed in 194 infants <6 months of chronological age between March 2013 and December 2015 were reviewed to identify factors that affect TST, including age of infant, location and timing of study, presence of medical complexity, and presence of nasal tubes. A continuum of apnea-hypopnea index (AHI) in relation to TST was reviewed. Data were examined in infants who had TST <4 hours and low AHI.

Results Greater TST (p < 0.001) was noted among infants during nocturnal PSGs, at older chronological and post-menstrual ages, and without medical complexity. The presence of nasogastric/impedance probes reduced TST (p = 0.002). Elevated AHIs were identified even in PSGs with TST <4 hours. Short TST may have affected interpretation and delayed initial management in one infant without any inadvertent complications.

Conclusion Clinical factors such as PMA and medical complexity, and potentially modifiable factors such as time of day and location of study appeared to affect TST during infant PSGs. TST < 4 hours can be sufficient to identify high AHI allowing physician interpretation.

Key Points

Less than 4 hours of TST is enough for interpretation of infant polysomnography.
Shorter TST appears related to infant age, medical complexity, and higher apnea-hypopnea index.
Modifiable factors seen with higher TST were time of day, environment, and presence of nasal tubes.

Keywords

infant - polysomnography - total sleep time - sleep disordered breathing

Full Text

References

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