{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:39:56Z","timestamp":1791038396191,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objectives<\/jats:title><jats:p>The aim of this study was to determine the impact of apneas on oxygen saturation and the presence of intermittent hypoxia, during sleep of preterm infants (PTIs) born at high altitudes and compare with full-term infants (FTIs) at the same altitude.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PTIs and FTIs from 3 to 18 months were included. They were divided into three age groups: 3\u20134 months (Group 1); 6\u20137 months (Group 2), and 10\u201318 months (Group 3). Polysomnography parameters and oxygenation indices were evaluated. Intermittent hypoxia was defined as brief, repetitive cycles of decreased oxygen saturation. Kruskal-Wallis test for multiple comparisons, t-test or Mann\u2013Whitney U-test were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>127 PTI and 175 FTI were included. Total apnea-hypopnea index (AHI) was higher in PTI that FTI in all age groups (Group 1: 33.5\/h vs. 12.8\/h, p = 0.042; Group 2: 27.0\/h vs. 7.4\/h, p &amp;lt; 0.001; and Group 3: 11.6\/h vs. 3.1\/h, p &amp;lt; 0.001). In Group 3, central-AHI (8.0\/h vs. 2.3\/h, p &amp;lt; 0.001) and obstructive-AHI (1.8\/h vs. 0.6\/h, p &amp;lt; 0.008) were higher in PTI than FTI. T90 (7.0% vs. 0.5, p &amp;lt; 0.001), oxygen desaturation index (39.8\/h vs. 11.3, p &amp;lt; 0.001) were higher in PTI than FTI, nadir SpO2 (70.0% vs. 80.0, p&amp;lt;0.001) was lower in PTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>At high altitude, compared to FTI, PTI have a higher rate of respiratory events, greater desaturation, and a delayed resolution of these conditions, suggesting the persistence of intermittent hypoxia during the first 18 months of life. This indicates the need for follow-up of these infants for timely diagnosis and treatment of respiratory disturbances during sleep.<\/jats:p><\/jats:sec>","DOI":"10.1093\/sleep\/zsab208","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T09:02:54Z","timestamp":1629363774000},"source":"Crossref","is-referenced-by-count":5,"title":["Intermittent hypoxia and respiratory patterns during sleep of preterm infants aged 3 to 18 months residing at high altitude"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-5725","authenticated-orcid":false,"given":"Elida","family":"Duenas-Meza","sequence":"first","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"},{"name":"Universidad de La Sabana , Chia , Colombia"},{"name":"Fundaci\u00f3n Cardioinfantil \u2013 Instituto de Cardiolog\u00eda , Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel","family":"Escamilla-Gil","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"},{"name":"Universidad de La Sabana , Chia , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Angelica","family":"Bazurto-Zapata","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"},{"name":"Universidad de La Sabana , Chia , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Caparo","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Suarez Cuartas","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"},{"name":"Universidad de La Sabana , Chia , Colombia"},{"name":"Fundaci\u00f3n Cardioinfantil \u2013 Instituto de Cardiolog\u00eda , Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rinc\u00f3n Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizbeth","family":"Pernett Buenaver","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"},{"name":"Universidad de La Sabana , Chia , Colombia"},{"name":"Fundaci\u00f3n Cardioinfantil \u2013 Instituto de Cardiolog\u00eda , Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Rojas Ortega","sequence":"additional","affiliation":[{"name":"Universidad de La Sabana , Chia , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Torres","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3870-4102","authenticated-orcid":false,"given":"Sonia","family":"Restrepo-Gualteros","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Parra Buitrago","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"},{"name":"Universidad de La Sabana , Chia , Colombia"},{"name":"Fundaci\u00f3n Cardioinfantil \u2013 Instituto de Cardiolog\u00eda , Bogot\u00e1 , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0768-1972","authenticated-orcid":false,"given":"Mauricio","family":"Gonzalez-Garcia","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Neumol\u00f3gica Colombiana , Sleep center, Bogot\u00e1 , Colombia"},{"name":"Universidad de La Sabana , Chia , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"key":"2023031316283336000_","author":"World Health Organization.","year":"2018"},{"issue":"10063","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1016\/S0140-6736(16)31593-8","article-title":"Global, regional, and national causes of under-5 mortality in 2000\u201315: an updated systematic analysis with implications for the Sustainable Development Goals","volume":"388","author":"Liu","year":"2016","journal-title":"Lancet."},{"issue":"2","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"210.e211","DOI":"10.1016\/j.ajog.2014.08.024","article-title":"Preterm birth risk at high altitude in Peru","volume":"212","author":"Levine","year":"2015","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.5665\/sleep.2192","article-title":"Sleep apnea in early childhood associated with preterm birth but not small for gestational age: a population-based record linkage study","volume":"35","author":"Raynes-Greenow","year":"2012","journal-title":"Sleep."},{"issue":"3","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.clp.2019.05.006","article-title":"Intermittent hypoxemia in preterm infants","volume":"46","author":"Di Fiore","year":"2019","journal-title":"Clin Perinatol."},{"issue":"2","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.resp.2013.05.026","article-title":"Apnea of prematurity \u2013 perfect storm","volume":"189","author":"Di Fiore","year":"2013","journal-title":"Respir Physiol Neurobiol."},{"issue":"6","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1093\/ije\/dyz075","article-title":"Preterm birth and risk of sleep-disordered breathing from childhood into mid-adulthood","volume":"48","author":"Crump","year":"2019","journal-title":"Int J Epidemiol."},{"issue":"4","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/BF00442298","article-title":"Infant sleep apnea profile: preterm vs. term infants","volume":"143","author":"Albani","year":"1985","journal-title":"Eur J Pediatr."},{"issue":"4","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1067\/mpd.2003.28","article-title":"Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: association with race and prematurity","volume":"142","author":"Rosen","year":"2003","journal-title":"J Pediatr."},{"issue":"3","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1001\/jamapediatrics.2013.4371","article-title":"Effects of caffeine on intermittent hypoxia in infants born prematurely: a randomized clinical trial","volume":"168","author":"Rhein","year":"2014","journal-title":"JAMA Pediatr."},{"issue":"1","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1378\/chest.14-3207","article-title":"Overnight Polysomnographic characteristics and oxygen saturation of healthy infants, 1 to 18 months of age, born and residing at high altitude (2,640 meters)","volume":"148","author":"Duenas-Meza","year":"2015","journal-title":"Chest."},{"key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"103318","DOI":"10.1016\/j.resp.2019.103318","article-title":"Mechanistic actions of oxygen and methylxanthines on respiratory neural control and for the treatment of neonatal apnea","volume":"273","author":"Mitchell","year":"2020","journal-title":"Respir Physiol Neurobiol."},{"issue":"5","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1542\/peds.2004-1915","article-title":"Age terminology during the perinatal period","volume":"114","author":"Engle","year":"2004","journal-title":"Pediatrics."},{"key":"2023031316283336000_","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.6","author":"Berry","year":"2020"},{"issue":"2","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"201","DOI":"10.5664\/jcsm.26819","article-title":"The visual scoring of sleep and arousal in infants and children","volume":"3","author":"Grigg-Damberger","year":"2007","journal-title":"J Clin Sleep Med."},{"key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"89.e1","DOI":"10.1016\/j.jpeds.2018.08.048","article-title":"Intermittent hypoxemia in infants born late preterm: a prospective cohort observational study","volume":"204","author":"Williams","year":"2019","journal-title":"J Pediatr."},{"key":"2023031316283336000_","volume-title":"Applied Statistics for the Behavioral Sciences","author":"Hinkle","year":"2003","edition":"5th ed"},{"issue":"3","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"e0121945","DOI":"10.1371\/journal.pone.0121945","article-title":"cocor: a comprehensive solution for the statistical comparison of correlations","volume":"10","author":"Diedenhofen","year":"2015","journal-title":"PLoS One."},{"issue":"11","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1093\/sleep\/28.11.1428","article-title":"Sleep architecture in term and preterm infants beyond the neonatal period: the influence of gestational age, steroids, and ventilatory support","volume":"28","author":"Hoppenbrouwers","year":"2005","journal-title":"Sleep."},{"issue":"5","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1203\/00006450-199311000-00013","article-title":"Sleep state organization in premature infants of less than 35 weeks\u2019 gestational age","volume":"34","author":"Curzi-Dascalova","year":"1993","journal-title":"Pediatr Res."},{"issue":"3","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/0929-693X(96)81138-9","article-title":"Development of the sleep and autonomic nervous system control in premature and full-term newborn infants","volume":"2","author":"Curzi-Dascalova","year":"1995","journal-title":"Arch Pediatr."},{"issue":"6","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1055\/s-0038-1637760","article-title":"Respiratory instability and hypoxemia episodes in preterm infants","volume":"35","author":"Bancalari","year":"2018","journal-title":"Am J Perinatol."},{"issue":"8","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1002\/ppul.24354","article-title":"Associations between age and sleep apnea risk among newborn infants","volume":"54","author":"Matlen","year":"2019","journal-title":"Pediatr Pulmonol."},{"key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jpeds.2016.11.081","article-title":"The longitudinal effects of persistent apnea on cerebral oxygenation in infants born preterm","volume":"182","author":"Horne","year":"2017","journal-title":"J Pediatr."},{"issue":"23","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"6021","DOI":"10.1113\/JP275686","article-title":"Comparison of the longitudinal effects of persistent periodic breathing and apnoea on cerebral oxygenation in term- and preterm-born infants","volume":"596","author":"Horne","year":"2018","journal-title":"J Physiol."},{"issue":"3","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1203\/PDR.0b013e3180db29e5","article-title":"Postnatal development of periodic breathing cycle duration in term and preterm infants","volume":"62","author":"Wilkinson","year":"2007","journal-title":"Pediatr Res."},{"issue":"6","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.sleep.2015.02.537","article-title":"The longitudinal effects of persistent periodic breathing on cerebral oxygenation in preterm infants","volume":"16","author":"Decima","year":"2015","journal-title":"Sleep Med."},{"issue":"3","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jpeds.2011.02.011","article-title":"Longitudinal assessment of hemoglobin oxygen saturation in preterm and term infants in the first six months of life","volume":"159","author":"Hunt","year":"2011","journal-title":"J Pediatr."},{"issue":"9","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.5665\/sleep.4980","article-title":"Preterm Infants exhibit greater variability in cerebrovascular control than term Infants","volume":"38","author":"Fyfe","year":"2015","journal-title":"Sleep."},{"issue":"2","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1089\/152702903322022820","article-title":"Cardiopulmonary transition in the high altitude infant","volume":"4","author":"Niermeyer","year":"2003","journal-title":"High Alt Med Biol."},{"key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.earlhumdev.2017.07.003","article-title":"Review of sleep-EEG in preterm and term neonates","volume":"113","author":"Dereymaeker","year":"2017","journal-title":"Early Hum Dev."},{"issue":"2","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1590\/0004-282X20140214","article-title":"Sleep deprivation, pain and prematurity: a review study","volume":"73","author":"Bonan","year":"2015","journal-title":"Arq Neuropsiquiatr."},{"issue":"6","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1590\/0034-7167.2015680616i","article-title":"Polysomnography assessment of sleep and wakefulness in premature newborns","volume":"68","author":"Llaguno","year":"2015","journal-title":"Rev Bras Enferm."},{"issue":"2","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.resp.2010.11.011","article-title":"Respiratory variability in preterm and term infants: effect of sleep state, position and age","volume":"175","author":"Elder","year":"2011","journal-title":"Respir Physiol Neurobiol."},{"issue":"6","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"1750023","DOI":"10.1142\/S012906571750023X","article-title":"An automated quiet sleep detection approach in preterm infants as a gateway to assess brain maturation","volume":"27","author":"Dereymaeker","year":"2017","journal-title":"Int J Neural Syst."},{"issue":"1","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jsmc.2013.10.009","article-title":"Central Sleep Apnea in Infants","volume":"9","author":"Khan","year":"2014","journal-title":"Sleep Med Clin"},{"key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.jpeds.2018.10.015","article-title":"Cardiovascular autonomic control is altered in children born preterm with sleep disordered breathing","volume":"206","author":"Thomas","year":"2019","journal-title":"J Pediatr."},{"issue":"11","key":"2023031316283336000_","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsy161","article-title":"Assessing ventilatory instability using the response to spontaneous sighs during sleep in preterm infants","volume":"41","author":"Edwards","year":"2018","journal-title":"Sleep"},{"issue":"2","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.jpeds.2008.01.040","article-title":"Prenatal and neonatal risk factors for sleep disordered breathing in school-aged children born preterm","volume":"153","author":"Hibbs","year":"2008","journal-title":"J Pediatr."},{"issue":"4","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"737","DOI":"10.5665\/sleep.5618","article-title":"Perinatal risk factors associated with the obstructive sleep apnea syndrome in school-aged children born preterm","volume":"39","author":"Tapia","year":"2016","journal-title":"Sleep."},{"key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jpeds.2019.05.053","article-title":"Prenatal, perinatal, and early childhood factors associated with childhood obstructive sleep apnea","volume":"212","author":"Chen","year":"2019","journal-title":"J Pediatr."},{"issue":"1","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1542\/peds.2011-1504","article-title":"Preterm birth alters the maturation of baroreflex sensitivity in sleeping infants","volume":"129","author":"Witcombe","year":"2012","journal-title":"Pediatrics."},{"issue":"3","key":"2023031316283336000_","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.resp.2010.04.009","article-title":"The role of CO2 and central chemoreception in the control of breathing in the fetus and the neonate","volume":"173","author":"Darnall","year":"2010","journal-title":"Respir Physiol Neurobiol."}],"container-title":["Sleep"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsab208\/40404696\/zsab208.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/45\/1\/zsab208\/49517517\/zsab208.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/article-pdf\/45\/1\/zsab208\/49517517\/zsab208.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T15:22:42Z","timestamp":1699370562000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sleep\/article\/doi\/10.1093\/sleep\/zsab208\/6354695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,19]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,8,19]]},"published-print":{"date-parts":[[2022,1,11]]}},"URL":"https:\/\/doi.org\/10.1093\/sleep\/zsab208","relation":{},"ISSN":["0161-8105","1550-9109"],"issn-type":[{"value":"0161-8105","type":"print"},{"value":"1550-9109","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,1,1]]},"published":{"date-parts":[[2021,8,19]]},"article-number":"zsab208"}}