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Aim: To compare the overnight 12-hour oximetry component of 24-hour oximetry recordings with the complete 24-h recording in terms of cardiorespiratory status data in preterm infants.Methods: Preterm infants from the Wellington neonatal intensive care unit underwent a 24-h pulse oximetry recording immediately prior to discharge home. Each recording was edited to resemble a 12-h overnight recording and compared to the full 24-h recording. Differences in a range of cardiorespiratory variables were assessed as to whether they were statistically significant and, if so, likely to be clinically significant.Results: The nadirs for heart rate and SpO2 (both P < 0.001), the time spent <80% SpO2 (P = 0.017) and highest heart rate (P < 0.001) were significantly different between the two recordings. Only the heart rate nadir differed by more than 5%, suggesting that this may be of clinical significance (median (interquartile range) 54 (28-69) for 24-h recording vs. 78 (54-96) for 12-h recording).Conclusion: The 24-h oximetry reports were clinically similar to 12-h recordings for the majority of variables, and therefore, we suggest that 12-h oximetry studies are sufficient for determining cardiorespiratory status in infants. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Continuous positive airway pressure (CPAP) is an effective treatment of obstructive sleep apnoea (OSA), but can be limited by poor adherence. In New Zealand (NZ), ethnicity has been shown to be a predictor of CPAP adherence. This study aimed to explore Maori, Pacific and NZ European patients' experience of CPAP treatment. METHODS: Patients identifying as Maori, Pacific, or NZ European ethnicity referred for CPAP treatment for OSA attended separate, 1.5-hour group discussions facilitated by a health care worker of the same ethnic group, using an interview template. Thematic analysis was applied to the discussion transcripts independently by two investigators, following published guidelines. FINDINGS: Five Maori, five Pacific, and eight NZ Europeans participated (mean age 47, range 30-71 years, mean ± standard deviation CPAP adherence 6.32 ±1.25 hours/night). Patients in all three groups reported that they had little knowledge of OSA or CPAP prior to treatment initiation. All groups identified barriers to treatment (both at the CPAP initiation phase and long term), reported feelings of being 'overwhelmed' with information during the initial CPAP education session, and discussed the importance of successful role models. Family and friends were generally reported as being supportive of CPAP therapy. CONCLUSION: The three groups all reported similar initial CPAP experiences, highlighting access barriers to publicly funded assessment and treatment pathways, and sleep health knowledge as key issues. Educational resources to improve access, enable self-management, and increase community awareness of OSA would help overcome some of the issues identified in this study. [ABSTRACT FROM AUTHOR]

The reported association of cot death and sleeping prone could be due to rebreathing of expired gases. A mechanical model simulating the respiratory system of an infant, exhaling warm humidified air with an end tidal carbon dioxide of 5%, has been used to investigate this. Some commonly used bedding materials caused an accumulation of carbon dioxide of 7% to over 10% with the model lying face down. This phenomenon persisted even with the head inclined at 45 degrees, but only on very soft materials, and could be a cause of cot death in a baby unresponsive to asphyxial blood gas changes. A coir fibre mattress allowed complete dispersal of exhalate as did a rubber sheet between any mattress and the covering sheet. [ABSTRACT FROM AUTHOR]