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Evaluation of Obstructive Sleep Apnea in Prone Versus Nonprone Body Positioning With Polysomnography in Infants With

Hanna Hong1, Choo Phei Wee2, Karla Haynes3

  • 1Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|August 7, 2019
PubMed

Insights

Prone positioning may improve obstructive sleep apnea in infants with Robin sequence, but does not fully resolve it. Objective evaluation is crucial for individual infant therapy decisions.

Area of Science:

  • Pediatric Sleep Medicine
  • Craniofacial Anomalies
  • Respiratory Physiology

Background:

  • Robin sequence (RS) management often involves prone positioning, posing a conflict with safe infant sleep guidelines.
  • Obstructive sleep apnea (OSA) is a common complication in infants with RS.

Purpose of the Study:

  • To evaluate the impact of prone versus nonprone sleep positioning on polysomnography (PSG) parameters in infants with RS.
  • To determine if prone positioning improves OSA metrics in this population.

Main Methods:

  • A pre-post interventional, nonblinded study design was employed.
  • 11 infants with RS underwent polysomnography (PSG) with both nonprone and prone sleep positions.
  • Key PSG parameters including obstructive apnea-hypopnea index (oAHI), central apnea index (CAI), sleep efficiency (SE), and arousal index (AI) were analyzed.

Main Results:

  • Prone positioning showed a trend towards decreased median oAHI (16.0 to 14.0), CAI (2.9 to 1.0), and AI (28.0 to 19.9) (P = .065).
  • Sleep efficiency (SE) increased from 67.4% to 85.2% (P = .227) in the prone position.
  • While improvements were observed, complete resolution of obstruction was not achieved in any infant.

Conclusions:

  • Prone positioning may offer benefits for some infants with Robin sequence experiencing obstructive sleep apnea.
  • Therapeutic use of prone positioning requires careful, objective assessment for each infant.
  • Further research may be needed to optimize positioning strategies for RS patients.
Abstract

Keywords:
Robin sequenceinfantspolysomnographyprone

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