Sudden infant death syndrome: a digital computer-based apnoea monitor

Abstract

It has been postulated that the sudden infant death syndrome (s.i.d.s.) may sometimes be due to abnormal maturation or injury to the brain stem centres that regulate respiration. This functional abnormality of the brain stem respiratory centres may result in the interruption of the automatic inspiratory/expiratory cycle by recurrent periods of apnoea. There is a subgroup of infants known as ‘near-miss’ for s.i.d.s., who survived a prolonged apnoeic episode during sleep which may have resulted in death. In a number of recent studies, the near-miss infant has been clearly identified as an infant at high risk for s.i.d.s. Clinical studies conducted by using polygraphic and behavioural monitoring of near-miss infants have revealed numerous apnoeic episodes during sleep. Consequently, the clinical necessity of monitoring these babies in a paediatric care unit has become well established both for diagnostic purposes and for subsequent outpatient care. In view of these findings, it has become increasingly more important to develop advanced sophisticated computer methods for the on-line detection and processing of apnoeas during in-hospital monitoring of infants. This paper describes a digital computer method of on-line apnoea processing for application during the in-hospital monitoring of infants. The method is based on the application of Walsh transformations to the expired CO₂ signal measured in infants using a Beckman CO₂ analyser.