A study of short cessations and temporal dynamics of breathing in preterm infants

The current clinical definition of Apnea of Prematurity (AOP) in infants is cessations of breathing exceeding 20 s, or at least 10 s accompanied by bradycardia under 100 beats per minute (bpm) or desaturation below 80%. AOP has a negative effect on infant health as it can increase the risk of hypoxemia, hypoglycaemia, neurological injury and sepsis. However, the detrimental effects of AOP are poorly understood, in large part because apneas are difficult to monitor owing to limitations in the current modalities for monitoring respiration. This study investigates the respiratory dynamics of preterm infants by implementing, with modifications, a pre-existing breathing cessation-detection algorithm. Unlike other studies, we also analyze short cessations in breathing (2-5 s), so as to better quantify respiratory dynamics, temporally track respiratory stability and to investigate whether short cessations in breathing are related to apnea. We found that isolated 2-5 s cessations have a significant impact on the total time of breathing cessation, increasing it from 3.0% to 4.3%. Furthermore, short cessations in breathing are positively correlated to apnea. Finally, there are multiple periodic increases in cessations of breathing within a day.