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Longitudinal Sleep Outcomes in Neonates With Pierre Robin Sequence Treated Conservatively
Zarmina Ehsan1, Christopher Kurian2, K Nicole Weaver3
1Division of Pulmonary and Sleep Medicine, Children's Mercy-Kansas City, Kansas City, Missouri.
Summary
Neonates with Pierre Robin sequence (PRS) and obstructive sleep apnea (OSA) treated conservatively show improvements in breathing and sleep patterns with age. Obstructive sleep apnea resolved by a median of 15 months, suggesting natural improvement.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Craniofacial Anomalies
Background:
- Pierre Robin sequence (PRS) is a significant cause of neonatal obstructive sleep apnea (OSA).
- Longitudinal data on the age-related evolution of sleep-related respiratory parameters in infants with PRS are limited.
- Conservative management for PRS-related OSA, excluding tracheostomy or mandibular distraction, requires further investigation.
Purpose of the Study:
- To describe changes in sleep-related respiratory parameters and sleep architecture in neonates with PRS managed conservatively.
- To evaluate the natural course of obstructive sleep apnea (OSA) in infants with Pierre Robin sequence (PRS) under non-surgical treatment.
- To identify potential factors influencing the resolution of OSA in this cohort.
Main Methods:
- Retrospective analysis of 14-year data from a single institution.
- Inclusion of neonates with PRS who underwent diagnostic polysomnography (PSG) and at least one follow-up PSG.
- Exclusion of patients treated with surgery; analysis using mixed-effects models.
Main Results:
- A cohort of 21 infants with PRS and OSA was analyzed.
- Significant reductions in total apnea-hypopnea index (AHI), obstructive apnea-hypopnea index (OAHI), arousal index, and REM sleep percentage were observed with advancing age.
- Obstructive sleep apnea (OSA) resolved by a median age of 15 months in conservatively treated infants.
Conclusions:
- Neonates with PRS and OSA treated conservatively demonstrate improvement in OAHI with age.
- Craniofacial growth and respiratory control maturation are potential factors in OSA resolution.
- Further research is needed to assess the long-term effects of conservative management on growth and neurodevelopment.
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