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Original Research: Sleep Disorders |

Overnight Polysomnographic Characteristics and Oxygen Saturation of Healthy Infants, 1 to 18 Months of Age, Born and Residing At High Altitude (2,640 Meters)Healthy Infants Polysomnography at High Altitude

Elida Duenas-Meza, MD; María A. Bazurto-Zapata, MD; David Gozal, MD, FCCP; Mauricio González-García, MD; Joaquín Durán-Cantolla, MD, MBA; Carlos A. Torres-Duque, MD
Author and Funding Information

From Servicio de Sueño y Departamento de Investigación (Drs Duenas-Meza, Bazurto-Zapata, González-García, and Torres-Duque), Fundación Neumológica Colombiana, Bogotá, Colombia; Universidad La Sabana (Drs Duenas-Meza, Bazurto-Zapata, González-García, and Torres-Duque), Bogotá, Colombia; Section of Sleep Medicine (Dr Gozal), Department of Pediatrics, Comer Children’s Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL; and Servicio de Investigación (Dr Durán-Cantolla), Hospital Universitario Araba (BioAraba), Universidad del País Vasco (UPV/EHU), Vitoria, Spain.

CORRESPONDENCE TO: Elida Duenas-Meza, MD, Cra. 13 B No. 161-85 Cons:21, Fundación Neumológica Colombiana, Bogotá, Colombia; e-mail: eduenas@neumologica.org


FUNDING/SUPPORT: This study was supported by Departamento Administrativo de Ciencia y Tecnología de Colombia – COLCIENCIAS, and the Fundación Neumológica Colombiana. Dr Gozal is supported by National Institutes of Health [Grant HL65270] and by the Herbert T. Abelson Endowed Chair in Pediatrics.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(1):120-127. doi:10.1378/chest.14-3207
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BACKGROUND:  Approximately 8% of the world population resides above 1,600 m, with about 10 million people living above 2,500 m in Colombia. However, reference values for polysomnography (PSG) and oxygen saturation (Spo2) of children < 2 years old residing at high altitude are currently unavailable.

METHODS:  Healthy infants aged 1 to 18 months born and residing at high altitude (Bogotá: 2,640 m) underwent overnight PSG. Four age groups were defined: group 1, < 45 days; group 2, 3 to 4 months; group 3, 6 to 7 months; and group 4, 10 to 18 months. Of 122 children enrolled, 50 had three consecutive PSG tests and were analyzed as a longitudinal subcohort.

RESULTS:  A total of 281 PSG tests were performed in 122 infants (56% girls): group 1, 106 PSG tests; group 2, 89 PSG tests; group 3, 61 PSG tests; and group 4, 25 PSG tests. Active sleep diminished and quiet sleep increased with maturation. Apnea-hypopnea indexes (total, central, and obstructive) were highest in group 1 (21.4, 12.4, and 6.8/h total sleep time, respectively) and diminished with age (P < .001). Mean Spo2 during waking and sleep increased with age (P < .001). Nadir Spo2 values during respiratory events were lower in younger infants. Longitudinal assessments of 50 infants confirmed the temporal trends described for the cross-sectional dataset.

CONCLUSIONS:  Healthy infants (≤ 18 months old) born and residing at high altitude show preserved sleep architecture but higher apnea-hypopnea indexes and more prominent desaturation with respiratory events than do those living at low altitude. The current study findings can be used as reference values for infants at high altitude.

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