Central Sleep Apnoea Syndromes in Infants

During infancy sleep is at a lifetime maximum and the maturation of sleep is one of the most important physiological processes occurring during the first year of life, particularly the first 6 months. Sleep has a marked effect on cardiorespiratory control which is also rapidly maturing during infancy. Immaturity of cardiorespiratory control frequently leads to respiratory instability and prolonged pauses in breathing that manifest in apnoea of prematurity and periodic breathing. During infancy central apnoeas are common and obstructive apnoea rare. Although apnoea of prematurity is actively treated whilst preterm infants are in the neonatal intensive care unit (NICU), shorter apnoeas and periodic breathing go largely undetected and untreated. The hypoxia associated with apnoea of prematurity has been associated with adverse developmental outcomes, shorter central apnoeas are currently believed to be benign during this early period of development. However, there is growing evidence that these short central apnoeas may be associated with developmental deficits in neurocognition. Further research is required to optimise treatment of apnoea of prematurity and to identify if shorter central apnoeas also require treatment to improve developmental outcomes.