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Positive Airway Pressure for the Treatment of OSA in Infants

Christopher M Cielo1, Patricia Hernandez2, Alyssa M Ciampaglia3

  • 1Division of Pulmonary & Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Chest
|August 18, 2020
PubMed

Insights

Positive airway pressure (PAP) therapy is effective for treating obstructive sleep apnea (OSA) in infants, with high adherence rates similar to older children. This treatment should be considered for even the youngest patients with OSA.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Respiratory Care

Background:

  • Obstructive sleep apnea (OSA) is a significant concern in children.
  • Positive airway pressure (PAP) is a standard OSA treatment, but data in infants are limited.
  • Infants under 6 months represent a unique population for OSA management.

Purpose of the Study:

  • To compare the effectiveness and adherence of PAP therapy in infants younger than 6 months with school-aged children.
  • To assess if PAP can be successfully titrated in infants.
  • To identify barriers to PAP adherence in different pediatric age groups.

Main Methods:

  • A single-center retrospective study compared infants (<6 months) and school-aged children (5-10 years) with OSA treated with PAP.
  • Polysomnography data (baseline and post-titration), PAP adherence, and parent-reported barriers were analyzed.
  • Statistical comparisons were made between the infant and school-aged child groups.

Main Results:

  • Infants had a higher median obstructive apnea-hypopnea index (OAHI) at baseline compared to school-aged children.
  • PAP titration significantly reduced OAHI in both infants (92.1% median reduction) and children (93.4% median reduction).
  • PAP adherence was high in infants (94.7% of nights) and greater than in school-aged children (83% of nights).

Conclusions:

  • Objective data confirm that PAP is highly effective and well-tolerated for treating OSA in infants.
  • Adherence to PAP in infants is excellent, comparable to or exceeding that in older children.
  • PAP therapy should be strongly considered for OSA management in infants and young children, alongside other treatment options.
Abstract

Keywords:
CPAPOSApediatrics

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