The incidence of obstructive apneas in preterm infants with and without bronchopulmonary dysplasia.

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We tested the hypotheses that (1) preterm infants with bronchopulmonary dysplasia (BPD) have an increased incidence of obstructive apneas as compared to those without BPD (control) and (2) the respiratory pattern during obstructive apneas may be associated with more pronounced hypoventilation. Ventilation was measured with a flow-through system. We examined 2929 total apneas in 12 infants with BPD and 4366 apneas in 12 control infants matched for study weight (1.51 +/- 0.11 kg in the BPD group and 1.62 +/- 0.12 kg in the control group, P = 0.6) and for postconceptional age (33.3 +/- 0.8 weeks in the BPD group compared with 33.4 +/- 0.7 weeks in the control group, P = 0.6). The incidence of central apneas predominated in the BPD group (2551/2929, 87%) and in the control group (4188/4366, 96%). Obstructive apneas were more frequent in the BPD group (378/2929, 13%) than in the control group (178/4366, 4%, P = 0.004). The increased incidence of obstructive apneas in infants with BPD was observed in Quiet sleep (9.1 vs. 1.6%, P = 0.03) and in REM sleep (14.2 vs. 3.6%, P = 0.009). This increased incidence of obstructive apneas was applicable to short apneas (< 10 s, 10.9 vs. 2.7%, P = 0.003) and long apneas (> 10 s, 27.5 vs. 16.4%, P = 0.01). There were no significant changes in ventilatory pattern that could be uniquely attributed to one type of apnea. The findings suggest: (1) the great variability in the incidence of obstructive apneas reported in the literature relates, at least in part, to the clinical status of the infants and (2) ventilatory pattern is not a useful predictor of either type of apnea.