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We aimed to investigate the amount of time spent in periodic breathing (PB) and its consequences in preterm infants before and after hospital discharge.Preterm infants born between 28-32 weeks gestational age were studied during daytime sleep in the supine position at 32-36 weeks post menstrual age (PMA), 36-40 weeks PMA, 3 months and 6 months corrected age (CA). The percentage of total sleep time (TST) spent in PB (%TSTPB) was calculated and infants were grouped into below and above the median (8.5% TSTPB) at 32-36 weeks and compared with 36-40 weeks, 3 and 6 months.%TSTPB was not different between 32-36 weeks PMA (8.5%; 1.5, 15.0) (median, IQR) and 36-40 weeks PMA (6.6%, 0.9, 15.1), but decreased at 3 (0.4%; 0.0, 2.0) and 6 months CA (0%, 0.0, 1.1). Infants who spent above the median %TSTPB at 32-36 weeks PMA spent more %TSTPB at 36-40 weeks PMA (18.1%, 7.7, 23.9 vs 2.1%, 0.6, 6.4) and 6 months CA (0.9%, 0.0, 3.3) vs 0.0% (0.0, 0.0).Percentage sleep time spent in PB did not decrease as preterm infants approached term CA, when they were to be discharged home. High amounts of PB at 32-36 weeks PMA was associated with high amounts of PB at term CA (36-40 weeks PMA), and persistence of PB at 6 months CA.

To measure sleep patterns and quality, objectively and subjectively, in clinically stable children with cystic fibrosis (CF) and healthy control children, and to examine the relationship between sleep quality and disease severity.Clinically stable children with CF and healthy control children (7-18 years of age) were recruited. Sleep patterns and quality were measured at home with actigraphy (14 days). Overnight peripheral capillary oxygen saturation was measured via the use of pulse oximetry. Daytime sleepiness was evaluated by the Pediatric Daytime Sleepiness Scale (PDSS) and subjective sleep quality by the Sleep Disturbance Scale for Children and Obstructive Sleep Apnea-18.A total of 87 children with CF and 55 control children were recruited with no differences in age or sex. Children with CF had significantly lower total sleep time and sleep efficiency than control children due to frequent awakenings and more wake after sleep onset. In children with CF, forced expiratory volume in 1 second and overnight peripheral capillary oxygen saturation nadir correlated positively with total sleep time and sleep efficiency and negatively with frequency of awakenings and wake after sleep onset. Patients with CF had significantly greater Sleep Disturbance Scale for Children (45 vs 35; P .001), Obstructive Sleep Apnea-18 (35 vs 24; P .001), and PDSS scores (14 vs 11; P .001). There was a negative correlation between PDSS and forced expiratory volume in 1 second (r = -0.23; P .05).Even in periods of clinical stability, children with CF get less sleep than their peers due to more time in wakefulness during the night rather than less time spent in bed. Objective measures of sleep disturbance and subjective daytime sleepiness were related to disease severity. In contrast, parents of children with CF report high levels of sleep disturbance unrelated to disease severity.

Objective To determine whether sustained resolution of sleep disordered breathing (SDB) in young children, either because of treatment or spontaneous recovery, predicted long-term improvements in quality of life, family functioning, and parental stress. Study design Children diagnosed with primary snoring (n = 16), mild obstructive sleep apnea (OSA, n = 11), moderate-severe (MS) OSA (n = 8), and healthy nonsnoring controls (n = 25) at ages 3-5 years underwent repeat polysomnography at 6-8 years. Parents completed quality of life and parental stress questionnaires at both time points. Resolution of SDB was determined as obstructive apnea hypopnea index (OAHI) ≤1 event/hour, or absence of snoring during polysomnography or on parent report. Linear mixed-model analyses determined the effects of resolution on psychosocial morbidity. OAHI was used to determine the predictive value of changes in SDB severity on psychosocial outcomes. Results Fifty percent of primary snoring, 45% mild OSA, and 63% MS OSA resolved, of which 67% received treatment. Children originally diagnosed with SDB continued to show significant psychosocial impairments compared with nonsnoring controls, irrespective of resolution. A reduction in OAHI predicted improvements in physical symptoms, school functioning, family worry and family relationships, and stress related to a difficult child. Conclusions Treatment was more likely to result in resolution of SDB if original symptoms were MS. Children originally diagnosed with SDB, irrespective of resolution, continued to experience psychosocial dysfunction suggesting additional interventions are required.