To the Editor:
Periodic breathing is indicative of immaturity of respiratory control
and is well recognized within the normal limits in both full term and
premature infants but unusual beyond infancy and at high altitude. We
would like to focus on the importance of recognizing and scoring the
pattern of periodic breathing in older children both clinically and in
the sleep laboratory as an abnormal breathing pattern that should draw
the attention of the treating physician into the possibility of
hindbrain malformation or other significant pathology.
Despite that sleep disordered breathing including central and
obstructive apneas with or without hypoventilation are well reported as
a manifestation of Chiari type I malformation, scoring periodic
breathing pattern beyond infancy has not been an area of focus.