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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
[Obstructive sleep apnea syndrome in young infants]
Eran Rosenberg1, Soliman Elkrinawi, Aviv Goldbart
1Department of Pediatrics B, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel.
Insights
Obstructive sleep apnea syndrome (OSAS) is prevalent in infants under two, causing increased healthcare use and morbidity. Early diagnosis and treatment of infant OSAS are crucial for preventing negative health outcomes.
Area of Science:
- Pediatrics
- Sleep Medicine
- Respiratory Medicine
Background:
- Obstructive sleep apnea syndrome (OSAS) is commonly diagnosed in children aged 3-6 years, often due to adenotonsillar hypertrophy.
- OSAS in children can lead to significant health issues, including neurocognitive, behavioral, growth, and cardiac problems.
- This study focuses on OSAS in infants younger than 2 years, an understudied demographic.
Purpose of the Study:
- To determine the clinical and sleep characteristics of OSAS in infants under 2 years old.
- To evaluate the morbidity and healthcare utilization associated with OSAS in this young population.
- To assess the impact of early diagnosis and treatment on health outcomes.
Main Methods:
- A retrospective study involving 35 infants under 2 years with suspected OSAS who underwent polysomnography.
- A control group of healthy, age, gender, and pediatrician-matched children was included for comparison.
- Analysis of clinical data, sleep study results (e.g., apnea/hypopnea index), and healthcare utilization records.
Main Results:
- 33 out of 35 infants were diagnosed with OSAS, with a mean apnea/hypopnea index of 18.7 events/hour.
- Infants with OSAS showed significantly higher rates of primary care visits, emergency room visits, and hospitalizations compared to controls.
- OSAS patients had longer hospital stays and received more drug prescriptions; adenoidectomy improved AHI in 13 patients.
Conclusions:
- OSAS is a significant condition in infants younger than 2 years.
- Infants with OSAS experience higher morbidity and healthcare utilization than their healthy peers.
- Prompt diagnosis and intervention for infant OSAS are essential to mitigate associated health risks.
Unlabelled:
Obstructive sleep apnea syndrome (OSAS) has been reported among children aged 3-6 years. Adenotonsillar hypertrophy is the most common cause of OSAS. The upper airway obstruction results in repeated obstructive apneas and hypopneas, associated with oxygen desaturations and sleep fragmentation. OSAS in children is associated with higher respiratory morbidity as well as significant clinical consequences, mainly neurocognitive and behavioral problems, impaired growth and cardiac dysfunction. The objectives of the present study were to determine the clinical and sleep characteristics of OSAS in children younger than 2 years, and to evaluate morbidity and health care utilization of infants with OSAS. This retrospective study included 35 children younger than 2 years of age, referred for polysomnography because of suspected OSAS. The controL group included healthy children, matched by age, gender and pediatrician.
Results:
A total of 33 infants were diagnosed with OSAS. Mean apnea/hypopnea index [AHI) was 18.7 +/- 18.1 events/ hour [range 1.3-90.2]. In 10 infants a pattern of intermittent hypoxemia was observed. Infants with OSAS demonstrated a higher number of primary care clinic visits (20.8 +/- 14 vs. 12.1 +/- 6.6, P < 0.02). A higher percentage of children with OSAS visited the emergency room (60.6% vs. 32.2%, P < 0.03), and was hospitalized (36.3% vs. 12.9%, P < 0.03). Duration of hospitalization was also higher in the OSAS group [23.2 +/- 14.1% vs. 3 +/- 2.1%, P < 0.05). The number of drug prescriptions was higher among the study group [25.9 +/- 21.8% vs. 13.6 +/- 10.1, P < 0.03). Thirteen patients underwent adenoidectomy with or without tonsillectomy, resulting in improvement of AHI, decreasing from 26.4 +/- 24 before to 3.6 +/- 4.5 events per hour after surgery (p < 0.01).
Conclusions:
OSAS can be found in infants younger than 2 years of age. OSAS at this young age is characterized by a higher morbidity in comparison to healthy children. Early diagnosis and treatment may prevent morbidity in young children with OSAS.
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