Chest
Clinical InvestigationsSLEEPNasal Continuous Positive Airway Pressure Use In Children With Obstructive Sleep Apnea Younger Than 2 Years of Age
Section snippets
Materials and Methods
We retrospectively examined the last 18 patients < 2 years of age who had received a diagnosis of OSA by standard clinical polysomnography and who consented to the use of nasal CPAP as an elective treatment for their OSA. If a correctable cause of OSA was not considered as an effective alternative at the time of evaluation, CPAP was presented to the parents and referring physicians as an alternative treatment for OSA.
All polysomnography was completed using a polysomnograph (model 78D; Grass;
Results
All patients were < 2 years of age at the time of the initial CPAP study; 11 patients were < 1 year of age, and 7 patients were between 1 and 2 years of age.
The studied children had a variety of medical disorders that were thought to be contributing factors to their OSA. Patient diagnoses and final known dispositions are listed in Tables 1 and 2 .
Patients selected for CPAP use fell into four group types. In group 1, six OSA patients underwent a tracheostomy to treat their existing OSA. These
Discussion
These data demonstrate that CPAP is an effective treatment for OSA in patients who are < 2 years old across a wide disease spectrum. This study supports and extends the findings of Guilleminault and colleagues16 concerning OSA in infants < 1 year of age to those < 2 years of age. An important finding of this study was that OSA resolved over time in nine children. It is unlikely that CPAP “cured” OSA. OSA resolution may have resulted, in part, from the nature of the children's disorders
Conclusion
The main findings of this study were the following: (1) CPAP improved OSA in all study patients; (2) CPAP can be accepted and tolerated well by a majority of patients with severe OSA who are < 2 years of age; (3) CPAP is an effective treatment modality in children with OSA; and (4) CPAP was not a permanent treatment, as nine patients no longer required CPAP based on follow-up polysomnography-documented resolution of OSA. Some of these patients had self-limiting medical problems for which CPAP
ACKNOWLEDGMENT
The authors thank Michelle Gasca for data compilation and Grennith Zimmerman, PhD, for help in the statistical analysis of the data.
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