title: Apparent life-threatening events could be a wake-up call for sleep disordered breathing.
abstract: Polysomnographic recordings of children with an apparent life-threatening event (ALTE) have often displayed signs of partial or complete obstruction during sleep. Various studies have focused on facial dysmorphia in infants with ALTE and tried to establish a correlation between ALTE and obstructive sleep apnoea. Our study evaluates the phenotypic characteristics and the presence of sleep disorders in pre-school children who had at least one ALTE in the first year of life.
  
  
  
  We analyzed a group of pre-school children (mean age 5.21 ± 0.90 years) who were referred for an ALTE between 2008 and 2010. Children with no history of ALTEs were recruited as a control group. A detailed personal and family history was obtained for all the participants. Moreover, all the children underwent a general clinical examination and an ear, nose, and throat and orthodontic assessment. A clinical score was calculated according to the previously validated Sleep Clinical Record (SCR).
  
  
  
  In the ALTE group (n = 107), snoring (25.2% vs. 6.1%), apnoeas (19.6% vs. 4.3%), restless sleep (31.7% vs. 6.1%), and habitual mouth breathing (35.5% vs. 12.2%, P < 0.05) were significantly more common (P < 0.05) than in the control group (n = 115). The ALTE group also displayed a higher frequency of Angle class II (27.1% vs. 15.7%, P < 0.05), narrow palate (72.9% vs. 51.3%, P < 0.05), and Friedman palate position (grades III-IV) (31.7% vs. 16.6%, P < 0.05) than the control group. Moreover, 38/107 (35.5%) children in the ALTE group had a positive SCR score compared with 14/115 controls (12.2%) (P < 0.05).
  
  
  
  Pre-school age children with previous ALTE had a higher frequency of sleep disordered breathing and malocclusion phenotypes. The occurrence of ALTEs may be predictive of the development of sleep disordered breathing and highlight the importance of a long-term follow-up. Pediatr Pulmonol. 2016;51:1403-1408. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Faculty of Medicine and Psychology, Department of Neuroscience, Mental Health and Sense Organs, Pediatric Sleep Disorder Centre, Sant'Andrea Hospital, "Sapienza" University, Rome, Italy.
authors.forename: Jole
authors.initials: J
authors.lastname: Rabasco
authors.affiliation: Center for Pediatric Sleep Medicine and SIDS, Regina Margherita Children's Hospital, Città della Salute e della Scienza di Torino, Department of Pediatrics, University of Turin, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vigo
authors.affiliation: Faculty of Medicine and Psychology, Department of Neuroscience, Mental Health and Sense Organs, Pediatric Sleep Disorder Centre, Sant'Andrea Hospital, "Sapienza" University, Rome, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: Vitelli
authors.affiliation: Center for Pediatric Sleep Medicine and SIDS, Regina Margherita Children's Hospital, Città della Salute e della Scienza di Torino, Department of Pediatrics, University of Turin, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Noce
authors.affiliation: Faculty of Medicine and Psychology, Department of Neuroscience, Mental Health and Sense Organs, Pediatric Sleep Disorder Centre, Sant'Andrea Hospital, "Sapienza" University, Rome, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Pietropaoli
authors.affiliation: Faculty of Medicine and Psychology, Department of Neuroscience, Mental Health and Sense Organs, Pediatric Sleep Disorder Centre, Sant'Andrea Hospital, "Sapienza" University, Rome, Italy.
authors.forename: Melania
authors.initials: M
authors.lastname: Evangelisti
authors.affiliation: Faculty of Medicine and Psychology, Department of Neuroscience, Mental Health and Sense Organs, Pediatric Sleep Disorder Centre, Sant'Andrea Hospital, "Sapienza" University, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Pia Villa
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D010159:Palate / Q000002:abnormalities*; D017286:Polysomnography; D012189:Retrospective Studies; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology
keywords: infant pulmonary function; lung pathology; pulmonology (general); respiratory and airway muscle; sleep medicine