Apnea in subsequent asymptomatic siblings of infants who had an apparent life-threatening event.

Infants experiencing apparent life-threatening events (ALTE) have been reported to have elevated frequencies of periodic breathing and obstructive apnea when compared to presumably normal control groups. Whether these characteristics extend to the siblings of ALTE infants remains unknown. This study compared, retrospectively, the apnea indices of 13 first-born infants experiencing an ALTE with their subsequent asymptomatic siblings who had undergone polygraphic sleep apnea evaluations (including electrocardiogram, chest wall movements, expired CO2, and transcutaneous pulse oximetry). Gestation, birthweight, age at study, apnea and periodic breathing indices, and oxygen desaturations were compared. Regression analyses revealed that adjustments for gestational and postnatal age eliminated differences in apnea indices. ALTE infants and their subsequent siblings experienced similar rates of apnea. Neither group had elevated rates of prolonged central apneas (greater than 10 seconds duration) or periodic breathing (greater than 5% sleep time). Neither group had subsequent severe apneas. The use of polygraphic study and cardiac/apnea monitors in subsequent siblings of ALTE are unnecessary and should be considered only when there is parental disagreement.