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CPAP/BiPAP improved obstructive sleep apnea in infants
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The use of continuous positive airway pressure/bilevel positive airway pressure offers the greatest objective improvement when used for treating obstructive sleep apnea in infants, according to study findings published in the Journal of the American Medical Association Otolaryngology – Head & Neck Surgery.
The retrospective study included 126 patients aged 0 to 12 months who were diagnosed as having obstructive sleep apnea by an abnormal polysomnography result, defined as an apnea-hypopnea index of at least 1.5 with follow-up results for at least 6 months after diagnosis.
Based on medical record review, Todd D. Otteson, MD, MPH, of the Children’s Hospital of Pittsburgh,and colleagues investigated outcomes of nonsurgical and surgical interventions aimed to treat infants with obstructive sleep apnea. The most common interventions and mean age at the time were anti-gastroesophageal reflux diseases treatment (69.8% at age 7 months); observation (26.2% at age 6 months); supplemental oxygen (24.6% at age 4 months); adenoidectomy (23.8% at age 15 months); other surgical (19.8% at age 7 months); continuous positive airway pressure/bilevel positive airway pressure (CPAP/BiPAP; 14.3% at age 16 months); supraglottoplasty (8.7% at age 6 months); tonsillectomy and adenoidectomy (7.1% at age 24 months); tracheostomy (5.6% at age 10 months); and other nonsurgical (5.6% at age 15 months). Some patients underwent more than one intervention.
Other surgical interventions included neurosurgical decompression, among patients who underwent ventriculoperitoneal shunt placement (n=2), meningomyelocele closure (n=2), Chiari decompression (n=1) and an intraventricular cyst fenestration (n=1).
In most cases, nonsurgical interventions were performed in the infants, but those infants aged 0 to 3 months underwent more surgical interventions (19.7%) compared with infants aged older than 3 to 9 months (11.7%).
Collected outcome measures included in the study were demographic data, comorbidities, interventions targeted to treat obstructive sleep apnea, and the subjective improvement of obstructive sleep apnea symptoms after the intervention.
Gastroesophageal reflux disease was the most common comorbidity (68.3%), followed by those affected with a congenital syndrome or craniofacial malformation (36.5%), with Down syndrome (7.9%) and cleft palate (7.1%) being the most common.
Researchers found that in patients who underwent both pre-intervention and post-intervention polysomnography studies, CPAP/BiPAP showed the highest mean percentage decrease in the apnea-hypopnea index (67.2% decrease), followed by tracheostomy (67%), observation (65.6%) and supraglottoplasty (65.3%).
Disclosure: The researchers report no relevant financial disclosures.
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