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Published on: December 6, 2016
Supplemental Oxygen for Treatment of Infants With Obstructive Sleep Apnea
Justin Brockbank1, Carmen Leon Astudillo2, Datian Che3
1Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.
Insights
Supplemental oxygen significantly reduced obstructive respiratory events in infants with obstructive sleep apnea (OSA). This treatment improved oxygenation without negatively impacting ventilation, suggesting it
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Neonatal Care
Background:
- Supplemental oxygen can decrease obstructive respiratory events during sleep.
- However, it may lead to alveolar hypoventilation.
- Limited data exists on its effects in infants with obstructive sleep apnea (OSA).
Purpose of the Study:
- To investigate the impact of supplemental oxygen on sleep and respiratory events in infants diagnosed with OSA.
- To evaluate changes in obstructive apnea-hypopnea index (AHI), oxygen saturation, and ventilation.
Main Methods:
- Retrospective study of 59 infants with OSA undergoing sleep studies.
- Comparison between room air polysomnography (RA-PSG) and supplemental oxygen polysomnography (O₂-PSG).
- Exclusion of split-night studies and inadequate sleep durations.
Main Results:
- Obstructive AHI decreased significantly from 19.7 to 10.6 (P < .001).
- Lowest oxygen saturation during obstructive apneas increased from 80.7% to 90.0% (P < .001).
- No significant difference in carbon dioxide levels, indicating preserved alveolar ventilation.
Conclusions:
- Supplemental oxygen effectively reduces obstructive respiratory events and improves oxygenation in infants with OSA.
- It does not adversely affect alveolar ventilation in this population.
- May be a viable treatment option for infants with OSA unsuitable for CPAP or surgery.
Study Objectives:
Supplemental oxygen has been shown to decrease the frequency of obstructive respiratory events during sleep, but may result in alveolar hypoventilation. Limited information exists on the effect of supplemental oxygen on sleep and respiratory events in infants with obstructive sleep apnea (OSA).
Methods:
We conducted a retrospective study of infants with OSA who had sleep studies performed from 2007-2012. All infants underwent a room air diagnostic sleep study (RA-PSG), followed by a sleep study while breathing supplemental oxygen via nasal cannula (O₂-PSG) on a separate night. Infants with split-night studies or with inadequate sleep time were excluded.
Results:
Fifty-nine infants met criteria for entry into analysis. The mean age of infants at the time of RA-PSG was 13.0 ± 11.7 weeks and at O₂-PSG was 15.4 ± 13.0 weeks. The obstructive AHI decreased from 19.7 ± 13.0 during RA-PSG to 10.6 ± 11.7 during O₂-PSG (P < .001). The duration of longest obstructive apnea increased from 11.0 ± 4.2 seconds to 13.4 ± 7.4 seconds (P = .01). The lowest saturation associated with obstructive apneas increased from 80.7 ± 6.8% to 90.0 ± 6.7% (P < .001). Carbon dioxide data showed no difference in ventilation after supplemental oxygen administration. There was no significant change in the spontaneous arousal index, however, the percentage of respiratory events associated with arousal increased from 20.7 ± 11.1% to 35.7 ± 19.7% (P < .001).
Conclusions:
Infants with OSA who received supplemental oxygen had a significant decrease in the frequency of obstructive respiratory events and improved oxygenation without adverse effect on alveolar ventilation. These data suggest that supplemental oxygen may be an effective treatment for infants with OSA who are not good candidates for continuous positive airway pressure or surgery.
Citation:
Brockbank J, Astudillo CL, Che D, Tanphaichitr A, Huang G, Tomko J, Simakajornboon N. Supplemental oxygen for treatment of infants with obstructive sleep apnea. J Clin Sleep Med. 2019;15(8):1115-1123.
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