0844 Isolated, Idiopathic Periodic Breathing in a School Age Child. (25th May 2022)

• Record Type: Journal Article
• Authors: Isaacs, Thomas; Valenzuela, Andrew; Malhotra, Sonal
• Is Part Of: Sleep. Volume 45(2022)Supplement 1
• Page Start: A363
• Page End: A364
• Publication Date: 2022-05-25
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsac079.838
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Periodic breathing (PB) is a well described physiologic phenomenon of infancy and usually resolves with age1. PB that persists outside of infancy has been described in association with various pathologies such as Chiari malformation, upper airway anomalies and genetic abnormalities2. Isolated PB that persists past infancy is less well described, and there is little data to guide subsequent management and clinical decision making. Report of Cases: Here we present a case of a 12-year-old female with isolated PB on polysomnography (PSG). She initially presented to our sleep center clinic with complaints of snoring, gasping during sleep and daytime sleepiness. She had no significant past medical history and not on any sleep-modifying medications. PSG was ordered to evaluate for suspected obstructive sleep apnea. Total sleep time was 7.75 hours with a mildly reduced amount of REM (16% of total sleep time). She had a total of 4 minutes of central sleep apnea that met AASM criteria for periodic breathing. This occurred exclusively during transitions between N1 and N2 and was not associated with hypoxemia nor hypocapnia. The patient's total apnea hypopnea index (AHI) was 2.97/hr, obstructive AHI 0.65/hr and central apnea index was 2.32/hr. Of note, this studywas not conducted at high altitude and was done in Houston (approximately 100 feet above sea level). Given the lack of significant sleep apnea, a conservative approach with nasal fluticasone and close follow-up was utilized. Conclusion: Though rare, this case highlights the possibility of PB being an incidental finding of PSG in otherwise healthy, school aged children. The need for further research as to the significance of this incidental finding is also emphasized. Support (If Any): 1. MacLean, Joanna E., Dominic A. Fitzgerald, and Karen A. Waters. "Developmental changes in sleep and breathing across infancy and childhood." Paediatric respiratory reviews 16.4 (2015): 276-284.2. Ghirardo, Sergio, et al. "Central apnea and periodic breathing in children with underlying conditions." Journal of Sleep Research (2021): e13388.