Periodic Breathing
Basics
DESCRIPTION
- A respiratory pattern consisting of regular oscillations in breathing amplitude
- Typically, a respiratory pattern in which ≥3 apneas lasting ≥3 seconds occur, separated by <20 seconds of respiration
ALERT
Don’t confuse periodic breathing with obstructive and/or central apnea.
Don’t confuse periodic breathing with obstructive and/or central apnea.
EPIDEMIOLOGY
- Usually absent in the first 48 hours of life
- More frequent during rapid eye movement (REM or active) sleep versus non-REM (quiet) sleep
- Less common in prone versus supine position
- In full-term infants
- Amount of periodic breathing usually <4% of total sleep time
- Amount gradually decreases through the 1st year of life.
- By 1 year of age, the mean amount of periodic breathing is <1% of total sleep time.
- In premature infants
- Amount of periodic breathing is higher than in full-term infants.
- Amount correlates inversely with gestational age.
PATHOPHYSIOLOGY
- No common pathologic finding
- Abnormalities, when they exist, are related to the underlying disorder causing the periodic breathing.
ETIOLOGY
- Periodic breathing can be seen in healthy infants, children, and adults.
- Abnormalities, in any component of the breathing control system, may result in an increased amount of periodic breathing.
- Possible etiologies
- A delay in detecting changes in blood gas values by the chemoreceptors
- Increased chemoreceptor gain
ASSOCIATED-CONDITIONS
- Periodic breathing in infants is associated with the following:
- Apnea of prematurity or infancy
- Familial history of sudden infant death syndrome (SIDS)
- Anemia of prematurity
- Hypoxemia
- Hypochloremic alkalosis
- Periodic breathing with adults is associated with the following:
- Cardiac abnormalities (especially congestive heart failure [CHF])
- Neurologic dysfunction (meningitis, encephalitis, brainstem dysfunction)
- Exposure to high altitudes
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Citation
Cabana, Michael D., editor. "Periodic Breathing." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14060/all/Periodic_Breathing.
Periodic Breathing. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14060/all/Periodic_Breathing. Accessed December 13, 2024.
Periodic Breathing. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14060/all/Periodic_Breathing
Periodic Breathing [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2024 December 13]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14060/all/Periodic_Breathing.
* Article titles in AMA citation format should be in sentence-case
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