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    Periodic Breathing

    Periodic Breathing is a topic covered in the Select 5-Minute Pediatrics Topics.

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    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.

    Epidemiology

    • Usually absent in the 1st 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

    Commonly 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 MD, ed. Select 5-Minute Pediatrics Topics. 7th ed. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14060/all/Periodic_Breathing. Accessed April 25, 2019.
    Periodic Breathing. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics. Available from https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14060/all/Periodic_Breathing
    Periodic Breathing [Internet]. In: Cabana MD, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2019 April 25]. 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
    TY - ELEC T1 - Periodic Breathing ID - 14060 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14060/all/Periodic_Breathing PB - Wolters Kluwer Health ET - 7 DB - Medicine Central DP - Unbound Medicine ER -