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Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea

R T Brouillette1, J J Manoukian, F M Ducharme

  • 1Department of Pediatrics, McGill University/Montreal Children's Hospital, 2300 Tupper St., Montreal, Quebec, Canada H3H 1P3.

The Journal of Pediatrics
|June 8, 2001
PubMed

Insights

Nasal fluticasone significantly reduced obstructive sleep apnea severity in children. This study suggests topical corticosteroids may effectively treat pediatric obstructive sleep apnea (OSA).

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Allergy and Immunology

Background:

  • Obstructive sleep apnea (OSA) in children is often linked to adenotonsillar hypertrophy.
  • Current treatments may not be sufficient for all pediatric OSA cases.

Purpose of the Study:

  • To evaluate the efficacy of a 6-week course of nasal glucocorticoid spray in reducing OSA severity in children.
  • To test the hypothesis that nasal fluticasone propionate can decrease the frequency of apneas and hypopneas.

Main Methods:

  • A randomized, triple-blind, placebo-controlled trial was conducted.
  • 25 children (aged 1-10 years) with polysomnography-proven OSA received either nasal fluticasone propionate or a placebo for 6 weeks.
  • The primary outcome measured was the change in the mixed/obstructive apnea/hypopnea index.

Main Results:

  • The mixed/obstructive apnea/hypopnea index decreased significantly in the fluticasone group (10.7 to 5.8) compared to the placebo group (10.9 to 13.1), P = .04.
  • More children in the fluticasone group experienced a decrease in their apnea/hypopnea index (12/13) versus the placebo group (6/12), P = .03.
  • Hemoglobin desaturation and respiratory movement/arousal frequencies also decreased more in the fluticasone group.

Conclusions:

  • Nasal fluticasone effectively decreased the frequency of mixed and obstructive apneas and hypopneas in children with OSA.
  • Topical corticosteroids, such as nasal fluticasone, show promise as a therapeutic option for ameliorating pediatric obstructive sleep apnea.
Abstract

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