Sleep Pattern Alterations and Brief Airway Obstructions in Overweight Infants

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Abstract
The sleep characteristics of 10 overweight infants were monitored polysomnographically and compared with those of 10 age- and sex-matched control infants with no weight excess. The infants were selected from a wellbabies clinic. Infants were assigned to the weight excess group if their weight was> 120% of ideal weightlheight for age. There were six boys and four girls in both groups, with a median age of 23.5 weeks in the weight excess group and 22.0 weeks in the control group. The infants with weight excess spent significantly less time sleeping in non-rapid-eye-movement (NREM) sleep stage 3-4 and more time in indeterminate sleep than their matched controls. The infants with weight excess had also significantly more gross body movements and more sleep stage shifts than the control infants. Brief airway obstructions were found significantly more frequently in the weight excess group than in the control group. Seven overweight infants showed a total of 74 brief airway obstructions; 41 occurred in NREM sleep stage 1 or 2 and 14 in rapideye-movement (REM) sleep. The median duration of the obstructive episodes was 8's (range 3-13 s). Of the 10 control subjects, only 2 had one obstructive episode each, lasting 3 and 4 s and occurring during REM sleep. Only one mixed apnea of 6.5 s was recorded in a 39-week-old overweight boy. The obstructive episodes were accompanied by a median fall in heart rate of 9% (range 0-51%) and by a median fall in oxygen saturation of 0.9% (range 0-10%). Our observations show that overweight infants have alterations in sleep stages and brief airway obstructions, indicating that these infants could suffer from an abnormal control of breathing during sleep.