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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Treatment of obstructive sleep apnea in infants with trisomy 21 using oral appliances

Annette Linz, Michael S Urschitz, Margit Bacher

    The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
    |October 25, 2012
    PubMed

    Insights

    Oral appliances may improve obstructive sleep apnea (OSA) in infants with trisomy 21 (TS21). Early intervention with specialized oral appliances shows promise in managing infant OSA.

    Area of Science:

    • Pediatric Pulmonology
    • Genetics and Rare Diseases
    • Sleep Medicine

    Background:

    • Infants with trisomy 21 (TS21) are at high risk for developing obstructive sleep apnea (OSA).
    • OSA in infants can lead to significant health complications.
    • Early diagnosis and intervention are crucial for managing OSA in this population.

    Purpose of the Study:

    • To retrospectively evaluate the efficacy of oral appliances in treating OSA in infants with TS21.
    • To assess the impact of oral appliances on the pharyngeal space and apnea index.
    • To determine if early treatment can improve OSA outcomes in infants with TS21.

    Main Methods:

    • Retrospective analysis of data from 51 infants with TS21 (mean age 2.7 months) who underwent polysomnography (PSG).
    • Evaluation of mixed-obstructive apnea index (MOAI) before and after treatment with oral appliances.
    • Specific focus on appliances incorporating velar extension to advance the tongue base.

    Main Results:

    • 53% of infants (27/51) were diagnosed with OSA (MOAI ≥ 1).
    • Median MOAI significantly improved from 2.3 to 0 (P < .05) in treated infants.
    • Three infants without OSA at baseline developed the condition by follow-up PSG.

    Conclusions:

    • Obstructive sleep apnea (OSA) can manifest in infancy in individuals with trisomy 21 (TS21).
    • Early treatment with oral appliances, particularly those with velar extension, may effectively improve OSA.
    • Oral appliances represent a viable alternative treatment for infant OSA in TS21.

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