Related Experiment Videos
Acetazolamide treatment for infantile central sleep apnea
H Philippi1, I Bieber, B Reitter
1Department of Pediatrics, Johannes Gutenberg-University, Mainz, Germany. philippi@kinder.klinik.uni-mainz.de
Insights
Low-dose acetazolamide significantly reduced central sleep apnea and improved oxygen saturation in infants. This treatment offers a potential solution for infantile sleep apnea and associated hypoxemia.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Sleep Medicine
Background:
- Central sleep apnea (CSA) is common in neonates and can lead to significant infant morbidity.
- Frequent CSA episodes correlate with decreased oxygen saturation, posing health risks.
Purpose of the Study:
- To evaluate the efficacy of low-dose acetazolamide in treating symptomatic central sleep apnea in infants.
- To assess the impact of acetazolamide on oxygen saturation levels in this population.
Main Methods:
- Twelve infants with CSA (apnea index >40/h) received acetazolamide (7 mg/kg/day) for 11 weeks.
- Polysomnography was conducted before treatment, during, and after the treatment course to monitor respiratory patterns and oxygen saturation.
Main Results:
- Acetazolamide treatment decreased the median central apnea index from 74/h to 13/h.
- The cumulative duration of oxygen saturation drops below 90% significantly reduced from 3.6 min/h to 0.07 min/h.
- Basal oxygen saturation improved from 95% to 98%, with sustained benefits post-treatment.
Conclusions:
- Low-dose acetazolamide effectively reduces central sleep apnea index and improves oxygenation in infants.
- Acetazolamide is a potentially safe and effective treatment for central infantile sleep apnea associated with hypoxemia.
Abstract:
Central sleep apnea is a common respiratory pattern in healthy neonates. Nevertheless, frequent central sleep apnea associated with drops in oxygen saturation may contribute to infantile morbidity. Recently, low-dose acetazolamide was shown to reduce symptomatic central sleep apnea in adults. We treated 12 infants, median conceptional age 42 weeks (range, 40-44 weeks), with central sleep apnea. In all cases, the central apnea index was >40/h total sleeping time (apnea > or = 3 sec). The cumulative duration of drops in oxygen saturation below 90% was more than 3 min/h total sleeping time. All individuals received acetazolamide 7 mg/kg/day (orally, divided in three doses) for 11 weeks. Polysomnography was begun 10 hours before the first dose and continued for 10 hours after the third dose. Polysomnography was repeated after 6 weeks of treatment and 1 week after acetazolamide therapy was discontinued. Comparison of the respiratory patterns before and after treatment (10-hour recording after the third dose) showed a decrease in the median central apnea index from 74/h (range, 42-152/h) to 13/h (range, 6-49/h). The median of the cumulative duration of drops in oxygen saturation below 90% decreased from 3.6 min/h (range, 3.1-9.2 min/h) to 0.07 min/h (range, 0-0.5 min/h). Basal oxygen saturation increased from 95 (92-97%) to 98% (96-99%). This improvement was maintained in the final polysomnography (12 weeks after therapy was begun and 1 week after completion of the 11-week course). No adverse effects were noted. We conclude that low-dose acetazolamide treatment may be useful for the treatment of central infantile sleep apnea associated with hypoxemia.