Home Infant Apnea Monitoring

Home monitors measure beat-to-beat heart rate and will alarm, usually within 3 seconds, if the rate is below a defined level. The heart rate alarm is usually set at 80 beats per minute (bpm) on discharge from the nursery and 60 bpm after about 3 months of age. There is usually a delay for apnea,  which implies absence of respiration, for 20 seconds. The monitors are impedance pneumographs which monitor chest wall movement. They provide information about central apnea (no chest wall movement and no air movement) but do not distinguish obstructive apnea. Caretakers are thaugt to respond to monitor alarms by initially checking the baby. If there is apnea, the baby is stimulated to alter state, which usually restores respiratory effort. Rarely, it is necessary to initiate CPR. Current monitors document the alarms and provide and event log that allows the clinician to evaluate the significance of the episodes.