Positive Airway Pressure for the Treatment of OSA in Infants (original) (raw)

Chest, 2021

Abstract

BACKGROUND Positive airway pressure (PAP) is a standard therapy for the treatment of obstructive sleep apnea syndrome (OSAS) in children, but objective data on effectiveness of PAP in infants are sparse. The aim of this study was to compare the effectiveness of PAP in infants <6 months old with school-age children. RESEARCH QUESTION Compared to school-age children, can PAP be titrated as successfully in infants and is adherence to PAP similar in both age groups? STUDY DESIGN and Methods: Single-center retrospective study. For consecutive infants <6 months old and school-age children 5-10 years old with OSAS treated with PAP, baseline and titration polysomnography data, PAP adherence data, and parent-reported barriers to adherence were compared between groups. RESULTS 41 infants and 109 school-age children were included. Median (interquartile range) obstructive apnea hypopnea index (OAHI) in infants was 25.7/hr (17.8,35.9) and was greater than school-age children (12.1/hr (7.6,21.5) (p<0.0001). After PAP titration, OAHI was reduced by (median) 92.1% in infants, similar to 93.4% in school-age children (p=0.67). PAP was used in infants on 94.7% of nights, which was greater than 83% in school-age children (p=0.003). There were no differences in barriers to adherence between infants and school-age children, with behavioral barriers being most common in both groups. INTERPRETATION Objective data demonstrates that PAP is both highly effective at treating OSAS and well-tolerated in infants. Like older patients, PAP should be considered along with other therapies for the treatment of OSAS in even the youngest children.

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