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Sve prestanke disanja novorođenčeta duže od 20 sekundi te kraće prestanke disanja popraćene bradikardijom i/ili hipoksemijom smatramo novorođenačkom apnejom. Najčešća je apneja nedonošenosti tj. idiopatska apneja. Etiologija ovog kliničkog entiteta nije u potpunosti razjašnjena, ali ključnim se etiološkim čimbenikom smatra nezrelost respiratorne kontrole. Od apneje nedonošenosti oboli gotovo sva nedonoščad rođena prije 28. tjedna trudnoće te praktički svi porodne mase manje od 1000 grama, a incidencija se smanjuje sukladno napredovanju korigirane dobi trudnoće. Obično se prva apneja detektira uređajem za nadzor disanja 2. ili 3. dan života, a do rezolucije najčešće dolazi u razdoblju od 36. do 40. tjedna korigirane dobi trudnoće. Prognoza je dobra, ali potencijalne dugoročne posljedice tek treba istražiti. Središnju ulogu u terapiji ima kofein. Njegovo se djelovanje zasniva na centralnoj stimulaciji disanja, a pokazao se jednostavnijim za primjenu i sigurnijim od drugih metilksantina. Često je u terapiju potrebno uvesti i neinvazivnu ventilaciju. Najčešće se primjenjuje nCPAP, ali istraživanja pokazuju potencijalne koristi primjene drugih modaliteta NIV-e kao što su biPAP, NAVA i HFNC. Manji se broj apneja ne može razriješiti primjenom navedenih metoda liječenja pa je neophodno uvesti invazivnu mehaničku ventilaciju. Iako rjeđe, novorođenačka se apneja javlja i u terminski rođene djece, uglavnom kao posljedica djelovanja raznih precipitirajućih čimbenika i bolesti pa njena rezolucija u ove novorođenčadi ovisi o liječenju primarne patologije., Neonatal apnea is defined as any cessation of breathing longer than 20 seconds or shorter cessations of breathing accompanied by bradycardia and/or hypoxemia. The most common is apnea of prematurity, also known as idiopathic apnea. The etiology of this clinical entity is not yet fully understood, but the most important etiological factor is considered to be immaturity of respiratory control. Almost all premature newborns born at less than 28 weeks of gestation and practically all who weigh less than 1000 grams at birth suffer from apnea of prematurity, but its incidence decreases in accordance with increasing postmenstrual age. Apnea is usually first detected by cardiorespiratory monitoring device on the second or third day of life and its resolution usually occurs between 36 and 40 weeks of postmenstrual age. Prognosis is good but potential long-term effects are yet to be investigated. Caffeine plays a central role in therapy. Its action is based on central stimulation of breathing and it has been shown as safer and easier to administer than other methylxanthines. The therapy often requires noninvasive ventilation. The most commonly used is nCPAP, but research shows the potential benefits of applying other NIV modalities such as biPAP, NAVA and HFNC. A small number of apneas cannot be resolved by applying the treatment methods mentioned above, so it is necessary to introduce invasive mechanical ventilation. Although less commonly, neonatal apnea also occurs in full term infants, mainly as a result of various precipitating factors and diseases, so its resolution in these newborns depends on the treatment of primary pathology.

Home monitoring supports the continuous improvement of the therapy by sharing data with healthcare professionals. It is required when life-threatening events can still occur after hospital discharge such as neonatal apnea. However, multiple sources of external noise could affect data quality and/or increase the misdetection rate. In this study, we developed a mechatronic platform for sensor characterizations and a framework to manage data in the context of neonatal apnea. The platform can simulate the movement of the abdomen in different plausible newborn positions by merging data acquired simultaneously from three-axis accelerometers and infrared sensors. We simulated nine apnea conditions combining three different linear displacements and body postures in the presence of self-generated external noise, showing how it is possible to reduce errors near to zero in phenomena detection. Finally, the development of a smart 8Ws-based software and a customizable mobile application were proposed to facilitate data management and interpretation, classifying the alerts to guarantee the correct information sharing without specialized skills.

Objective: To measure the accuracy of a novel device in detecting Bradycardia andDesaturation (B&D) events and to determine its efficacy in resolving apneas innewborns with comparison to standard monitor (which only detects B&D eventsand alerts).Design: This was a prospective observational study.Setting: Sick Newborn Care Unit of a large tertiary referral hospital in Hyderabad,India.Methods: 31 newborns were provided with a novel device, which monitored oxygensaturation and pulse rate and alarmed when values dropped below a set thresholdwhich is referred as an event, henceforth. The novel device also provided footstimulation in response to above-mentioned events. When the monitor alarmed, anurse attended to the baby to confirm whether the baby was breathing and whetherthe event had been resolved by the device. If the event had not resolved, appropriateaction as per the standard-of-care was performed.Results: The novel device “ApneBootTM” positively detected B&D events 94.03% oftimes as compared to the standard reference monitor. 56 of 67 observed B&D eventswere visually confirmed to be apneas, indicating that 83.6% of B&D eventscoincided with apneas. Of the 56 apneic events, 50 were central apneas, of which 35were resolved by the novel device, making the device’s efficacy of apnea resolution70%.Conclusion: The results of the study indicate that this novel device “ApneBootTM”is very effective in detecting and alarming B&D events, which coincides with theapnea, and resolving it by providing foot stimulation.Keywords: Novel Device, Neonatal Apnea, Low Birth Weight, Body Temperature,Kangaroo Mother Care, Community Health

The neonatal period of a child is considered the most important stage of its physical development and future health. Physiological parameters such as heart rate, respiratory waveform, blood oxygen saturation, and body temperature are continuously monitored by all NICUs. Neonatal Intensive Care Units are not always equipped with newborn computer-based systems and decision support to analyze these data, monitor prognosis, and determine significant events. In the developed data mart, it handles critical events and buildings, machine learning predictive models. The main purpose of treatment is to obtain information related to detection, diagnosis, monitoring, and treatment of disease. It acts as a data mining framework for neonatal care, decision support in key areas and risk classification. A well-developed predictive model will help improve NICU's clinical decision making. The introduce a new novel Multicollinear Gradient CatBoost Classification (MGCC) machine learning techniques to predict the model for apnea and analysis of drug dosage analysis as proposed. In this method to apply to find the missing attribute and normalize the feature values in dataset. To proposethe neonatal apnea and drugs it is based on features like heart rate, temperature, and blood purser. Boost is actually an ensemble of learning algorithms that combines estimates from multiple base stations to improve robustness with a single estimate. The data mining method is very useful for general building decision support systems in neonatal intensive care units because it provides support for the identification of neonatal diseases. In this proposed approach significantly perform better with improved classification accuracy and Specificity, in predicting neonatal apnea.

OBJECTIVES: First, to determine the feasibility of an ultra-compact wireless device (microEEG) to obtain multichannel electroencephalographic (EEG) recording in the Neonatal Intensive Care Unit (NICU). Second, to identify problem areas in order to improve wireless EEG performance. STUDY DESIGN: 28 subjects (gestational age 24–30 weeks, postnatal age

Background and Objective: Machine learning has been widely accepted and applied in different fields to analyze data, but it is still novel in the field of neonatal diseases, especially neonatal apnea prediction. Apnea is a breathing problem associated with pathological changes in heart rate and oxygen saturation and is a common occurrence in neonates especially those who are born preterm. This study is focused on prediction of apnea episodes during the first week of childʼs birth using machine learning algorithms. Materials and Methods: The data consists of 229 examples of neonates admitted to Neonatal Intensive Care Unit (NICU) of Kasturba hospital, Manipal, Karnataka, India. This data is preprocessed and used to develop classification model using machine learning techniques such as decision tree (C5.0), Support Vector Machine (SVM) and ensemble approach, which includes random forest for prediction of apnea episodes. Results: The study compares models (decision tree, SVM and ensemble approach such as random forest) for accuracy. Among the results obtained, an accuracy of 0.88 and kappa of 0.72 using random forest algorithm for mtry three is found to be the most accurate model. Conclusion: The research work provides an automated machine learning based solution that helps clinicians predict apnea in neonates during the first week of their life. Inclusion of contextual information and preprocessing technique along with heterogeneous ensemble approach may further improve the models performance.

OBJECTIVE: To determine the maternal perinatal morbility and mortality in the first pregnancy of the older women. MATERIAL AND METHODS: Retrospective and transversal study of 133 older women 35 years old or more who had their first pregnancy attended at Cayetano Heredia National Hospital between january 1st and december 31th 1996. They were compared with 5,006 women who had their first pregnancy at of 20 to 29 years old and attended in the same period of time. RESULTS: The incidence of maternal pathology is more frequent in the first pregnancy of older women with a relative risk (RR) 8,55 for previous arterial hypertension, 2,49 for eclampsia, 1,39 for pre eclampsia, 2,18 for cephalopelvic disproportion and 2,03 for hemorragia of third trimester of pregnancy. Cesarean section has a relative risk of 2,55. For the newborn the relative risk is highter for hyalina membrane (4,09), neonatal apnea (3,47), hyperbilirrubinemia (3,71), and congenital defects (1,5). The maternal mortality rate in older women was 751,9 x 100, 000 newborns and the rate for women 20 to 29 years was 172,3. The perinatal mortality rate type I was 29,6 per 1,000 newborns for the women and 19,6 in these women 20 to 29 years.

The potential for interaction between the peripheral (PCR) and central (CCR) chemoreflexes has not been studied in the neonatal period, when breathing is inherently unstable. Based on recent work in adult rodents, this study addresses the hypothesis that in neonatal mice there is a hypoadditive interaction between the chemoreflexes. To test this, a mask-pneumotach system was used to expose postnatal day (P) 11–12 mouse pups to square-wave hyperoxia (100% O2; n = 8) or hypoxia (10% O2; n = 11), administered in normocapnic conditions (inspired CO2 (FICO2) = 0.001–0.005), or following an episode of re-breathing to increase FICO2 by 0.015–0.02. The immediate (i.e. PCR-mediated) responses of frequency (fB), tidal volume (VT) and ventilation (V˙E) to square-wave hyperoxia and hypoxia were assessed. When given in a normocapnic background, hyperoxia induced an immediate (within the first 20 breaths, or ∼6 s) but transient fall in fB (−46 ± 9 breaths/min) and V˙E (−149 ± 41 μl min−1 g−1) (P < 0.001 for both), with no effect on VT. In contrast, hyperoxia had no influence on breathing when it was administered following re-breathing. Similarly, the hypoxia-induced increase in fB was greater when applied under normocapnic conditions (50 ± 8 breaths/min) then when applied following re-breathing (21 ± 5 breaths/min) (P = 0.02). These data demonstrate a hypo-additive interaction between the PCR and CCR with respect to the immediate frequency response to inhibition or excitation of the PCR. Hypoaddition of the chemoreflexes could cause or mitigate neonatal apnea, depending on the prevailing PCO2.

This study explored the feasibility effect and safety of the limb stimulation (LS) for the treatment of neonatal apnea (NAP). The cases of 30 eligible premature infants with NAP were included in this retrospective study. These cases were equally divided into an intervention group (n = 15) and a control group (n = 15). The infants in both groups received caffeine treatment. Moreover, cases in the intervention group also received LS for a total 30 hours, while the subjects in the control group did not receive LS during this period. The primary outcome included apnea frequency (number of episodes per 24 hours), and apnea rate. The secondary outcomes consisted of desaturation (number of episodes per 24 hours), and heart rate (beats per minute). Additionally, adverse events were also documented during the treatment period. After treatment, LS did not show better outcomes in apnea frequency (P = .48), apnea rate (P = .33), desaturation (P = .55), and heart rate (P = .41). Furthermore, no significant differences of all adverse events were found between 2 groups. The results of this pilot study demonstrated that LS might be not efficacious for premature infants with NAP.

Objective: To describe common etiologies and diagnostic evaluations performed on term and late preterm neonates with neonatal apnea and to compare these etiologies and evaluations with those infants with infantile acute life threat ening event (ALTE). Methods: Infants 35 weeks, with diagnosis of apnea or ALTE were identified at Bo ston Children's Hospital from June 2000 to June 2009. Medical rec ords were reviewed for diagnostic evaluations and discharge diagnoses. For analysis, neonates who presented with neonatal apnea within the first week of life and prior to discharge f rom the birth hospitalization were classified as the Inpatient Grou p and infants who presented with apnea post discharge were identified as the Outpatient Group. Infants with clear presenting etiologies were excluded from the study. Results: One hundred otherwise healthy subjects with diagnosis of apnea or ALTE in the study period were identified. Approxi- mately one third were classified as the Inpatient Group. Diag nostic evaluations were highly variable, but testing for ba cterial or viral sepsis was most commonly performed. In most cases, an etiology was not determined, and the diagnosis of "apnea of imma- turity" was assigned. Other defined etiologic diagnoses inc luded viral infection or pertussis, reflux/aspiration, lar yngomalacia, and seizures. Conclusions: Diagnostic evaluation for apnea, in otherwise well-appearing full-term and late preterm infants, remains highly variable. Testing for infection, seizure, laryngomalacia and reflux may determine the majority of treatable etiologie s. Guidelines for diagnostic evaluations and treatment strategies are cl early needed.

Preterm infants are subject to fluctuations in blood gas status associated with immature respiratory control. Intermittent hypoxia during early postnatal life has been shown to increase chemoreceptor sensitivity and destabilize the breathing pattern; however, intermittent hypercapnia remains poorly studied. Therefore, to test the hypothesis that intermittent hypercapnia results in altered respiratory control, we examined the effects of daily exposure to intermittent hypercapnia on the ventilatory response to subsequent hypercapnic and hypoxic exposure in neonatal rat pups. Exposure cycles consisted of 5 min of intermittent hypercapnia (5% CO2, 21% O2, balance N2) followed by 10 min of normoxia. Rat pups were exposed to 18 exposure cycles each day for 1 week, from postnatal day 7 to 14. We analyzed diaphragm electromyograms (EMGs) from pups exposed to subsequent acute hypercapnic (5% CO2) and hypoxic (12% O2) challenges. In response to a subsequent hypercapnia challenge, there was no significant difference in the ventilatory response between control and intermittent hypercapnia-exposed groups. In contrast, intermittent hypercapnia-exposed rat pups showed an enhanced ventilatory response to hypoxic challenge with an increase in minute EMG to 118 ± 14% of baseline versus 107 ± 13% for control pups (p < 0.05). We speculate that prior hypercapnic exposure may increase peripheral chemoreceptor response to subsequent hypoxic exposures and result in perturbed neonatal respiratory control.

Introducción: La vídeo-polisomnografía (VPSG) neonatal está indicada para descartar la existencia de alteraciones respiratorias antes del alta hospitalaria y para estudiar el patrón de sueño del neonato y patologías asociadas. Objetivo: Estudiar la presencia de apneas, hipopneas y respiración periódica en prematuros de menos de 1.800 g y describir la variabilidad cardiorrespiratoria, las anomalías del electroencefalograma (EEG) y de la maduración cerebral en relación con el sueño. Método: Estudio descriptivo que revisa las historias clínicas de neonatos de peso inferior a 1.800 g a los que se había realizado VPSG (años 2001-2003). La indicación más frecuente fue la existencia de apneas y desaturación de oxígeno. Con los datos obtenidos se efectuó un estudio estadístico descriptivo. Resultados: El número de niños estudiados fue de 31, con una edad gestacional media de 27,8 semanas y un peso medio al nacimiento de 1.158 g. La patología asociada más frecuente fue enfermedad de membrana hialina en el 68 %. Se detectaron alteraciones cardiorrespiratorias en el 65 %; patrón de sueño alterado en el 6 %; y registro de EEG inmaduro en el 32 %, alterado en el 13 % e inmaduro y alterado en el 3 %. El 69 % de los casos necesitaron monitorización y el 23 % precisaron oxigenoterapia domiciliaria. Cuatro casos reingresaron en varias ocasiones por apneas. Conclusión: Queremos resaltar la importancia de realizar VPSG con una metodología adecuada en recién nacidos pretérmino con alteraciones cardiorrespiratorias o neurológicas, para detectar anomalías del EEG, de la maduración cerebral y de la respiración en relación con el sueño. : Introduction: Neonatal video-polysomnography (VPSG) in preterm infants is indicated to rule out sleep-related respiratory disturbances before discharge from neonatal units and to study neonatal sleep patterns and associated pathologic conditions. Objective: To study the presence of apnea, hypopnea, and periodic breathing in preterm infants with low birth weight (< 1,800 g) and to describe their cardio-respiratory variability, electroencephalogram (EEG) abnormalities, and brain maturity in connection with sleep stages. Method: We performed a cross-sectional, descriptive study through review of the clinical histories of preterm infants with a birth weight < 1,800 g who had undergone VPSG (2001-2003). The most common indication for VPSG was the presence of sleep apneas and oxygen desaturation. The data obtained were used for descriptive statistical analysis. Results: Thirty-one infants were studied, with a mean gestational age of 27.8 weeks and a mean birth weight of 1,158 g. The most frequently associated condition was hyaline membrane disease (68 %). Cardiorespiratory impairment was detected in 65 %, altered sleep pattern in 6 %, immature EEG recording in 32 %, abnormal pattern in 13 %, and immature plus abnormal pattern in 3 %. Sixty-nine percent of the infants required home monitoring and 23% needed oxygen at home. Four infants were readmitted on several occasions due to apnea. Conclusion: We wish to stress the importance of carrying out VPSG with suitable methodology in preterm infants with cardiorespiratory or neurological impairment in order to detect abnormalities on EEG and to assess brain maturity and sleep-related abnormal respiratory events.

Theophylline is an extremely potent drug that was once the mainstay of therapy for asthma int he United States. Over the last 2 decades, use of theophylline has decreased markedly as safer, more effective bronchodilators have been created. However, theophylline remains commonly used outside this country. Even in the United States, it continues to have a role in the management of neonatal apnea and moderate-to-severe asthma. With the guarantee of theophylline's continued use, it is essential for clinicians to recognize the causes, manifestations, and consequences of theophylline intoxication. This report provides such a summary, along with currently recommended practice guidelines for the treatment of theophylline poisoning.

La apnea obstructiva del sueño o hipoventilación obstructiva en neonatos, es distinta que en los adultos y también lo son su presentación, etiología y tratamiento. Se considera apnea del sueño cuando se produce 1 episodio de apnea por hora de más de 10 segundos de duración, con saturación menor del 87% e incremento del CO2. Existen varias causas, pero los factores anatómicos y neurofuncionales son la base del problema respiratorio superior que produce fallos en las fuerzas que contraen y dilatan la vía aérea. La retromicrognatia como causa anatómica, puede ser aislada o sindrómica. La hipoxemia y la hipercapnia aumentan la presión negativa intratorácica del paciente con la consecuencia de daño celular sin que se pueda cuantificar la gravedad de la lesión cerebral en esta etapa neonatal. En el presente estudio, observacional descriptivo, entre los años 2000 y 2011, en una serie de 49 pacientes neonatos de la Unidad de Cuidados Intensivos del Recién Nacido del Hospital Universitario del Valle y del Centro Médico Imbanaco de la ciudad de Cali, Colombia, pretendemos evidenciar los beneficios del tratamiento precoz de los neonatos que presentan retromicrognatia y apnea obstructiva o hipoventilación obstructiva, intervenidos quirúrgicamente mediante corticotomía, colocación de distractores y elongación mandibular, logrando que la apnea obstructiva desapareciera en un tiempo no superior a una semana y que la mejoría clínica de los recién nacidos con este diagnostico fuera evidente, evitando la traqueotomía y las posibles complicaciones y secuelas por hipoxia cerebral, a la vez que disminuyó la estancia hospitalaria. The obstructive sleep apnea or obstructive hypoventilation in neonates is different than on adults, therefore the presentation, etiology and treatment are different too; it's considered sleep apnea 1 episode an hour for more than 10 seconds, with saturation lower than 87% and increment of CO2. There are several etiological causes but anatomical and neurophysiological factors are the basis of upper respiratory problem that produces failures that produces forces that tighten and relax the airway. Retromicrognathia as the anatomical cause can be isolated or syndromic. Hypoxemia and hypercapnia increase the intrathoracic negative pressure with the consequence of cell damage without being able to quantify the severity of brain injury in the neonatal period. We present an observational descriptive study, case series conducted between 2000 and 2011, in 49 neonatal patients in the Intensive Care Unit of Valley University Hospital and Imbanaco Medical Center in Cali, Colombia. The study aims to show the benefits of early management of infants who developed retro-micrognathia and obstructive apnea or obstructive hypoventilation, which were surgically treated with corticotomy, placement of distractors and mandibular elongation, getting obstructive sleep apnea disappears in a time no more than a week and that clinical improvement of neonates with this diagnosis, avoiding tracheotomy and possible complications and consequences of cerebral hypoxia, and decreasing hospital stay.

Although a significant bibliography exists on the application of signal processing methods to ECG signals, the optimal configuration of these methods so as to maximize their performance on clinical data is a complex problem that is seldom covered in the literature. This is particularly the case for the signal processing chains proposed for the detection and segmentation of individual beats, which are often characterized by a significant number or parameters (filter cut-off frequencies, thresholds, etc.). In this chapter we propose an automated method, based on evolutionary computing, to optimize these parameters in a joint fashion. A brief state of the art on current ECG segmentation methods is presented and a complete signal processing chain, adapted to the detection and segmentation of ECG signals is proposed. The evolutionary optimization method is described and applied to two different monitoring applications: the detection of myocardial ischemia episodes on adult patients and the characterization of apnea-bradycardia events on preterm infants.

Pediatric breathing control disorders can be disastrous if not promptly recognized and treated. Diagnostic techniques and management options are discussed in the context of essential clinical features of five major entities: neonatal apnea, obstructive sleep apnea, central hypoventilation syndrome, "apparent life-threatening events," and sudden infant death syndrome.

The aim of the present study was to assess the effects of the different states of alertness on 1) nonnutritive swallowing (NNS) frequency, 2) the relationship between NNS and the respiratory cycle, and 3) the association of NNS with spontaneous apneas. Recordings of sleep states, diaphragm and laryngeal constrictor electrical activity, nasal flow, electrocardiogram, respiratory inductance plethysmography, and pulse oximetry were obtained from six preterm lambs without sedation. Analysis of 2,468 NNS showed that 1) NNS frequency was higher during quiet wakefulness and active sleep (AS) than in quiet sleep; 2) in all states of alertness, a greater number of NNS (38%) were preceded and followed by an inspiration; 3) although NNS and central apneas were rarely coincidental, AS appeared to favor their association; and 4) most obstructive apneas occurred in AS and were coincidental with bursts of NNS. Compared with results in full-term lambs, premature birth does not modify the NNS-respiratory coordination. However, AS in preterm lambs is characterized by a higher association of NNS bursts with obstructive apneas.

Premature infants are susceptible to apnea. Presently physical stimulation, administered to interrupt apneic episodes, is accomplished by hand contact, which is often delayed and presents infection risks. This study developed a software system to collect and analyze data to study the efficacy and safety of mechanical vibrotactile stimulation (VTS) as a means of interrupting an apneic episode. This software system was utilized to compare VTS (n=12) and hand stimulation (n=12). VTS and traditional hand stimulation were found to be equally effective in terminating apnea (9/12 (75%) vs. 10/12 (80%)). Mean time to resumption of breathing from onset of stimulation was similar (VTS 3.1/spl plusmn/2.6 seconds vs. hand 3.7/spl plusmn/4.1 seconds, p=0.67), as was total apnea duration (VTS 28.1/spl plusmn/12.1 seconds vs. hand 28.5/spl plusmn/5.2 seconds, p=0.93). The duration of VTS was half as long as hand stimulation (VTS 2.9/spl plusmn/1.7 seconds vs. hand 6.8/spl plusmn/5.4 seconds, p=0.05). No adverse effects of VTS were noted Overall, VTS was similar to hand stimulation in its ability to end apneic spells. Since the duration of VTS was half that of hand stimulation VTS seems more efficient in interrupting apnea.

161 Prenatal Nicotine Exposure Increases the Risk of Neonatal Apnea -A National Birth-Cohort Study

Currently the classification of neonatal apnea relies upon an inference of airway closure based upon the presence of breathing efforts against such an obstruction. In this study we evaluate a new method of classification which utilizes the presence or absence of cardiac airflow oscillation to detect airway closure. Specifically, this evaluation consisted of an examination of the transmission characteristics of an artificially produced airflow oscillation through discrete airway narrowing in a model system; a confirmation that voluntary upper airway occlusion in adult volunteers uniformly induces complete loss of the oscillation; and a comparison of the cardiac oscillation method with the traditional method of apnea classification in a cohort of 4,309 apneas in 32 infants. We determined that the amplitude of the oscillation is negatively correlated with resistance (r = 0.97) and positively with the radius (r = 0.98) of narrowing in a model system, and that voluntary airway obstruction in adult subjects uniformly results in loss of transmitted cardiac oscillations. Moreover, although there was similarity in the frequency distribution of central, obstructive, and mixed apneas in our infants, there were statistically significantly greater obstructive events detected by the cardiac oscillation method. In addition, the cardiac oscillation method had the additional advantage of providing information regarding the timing of airway obstruction during apnea.