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Positional device therapy for the treatment of positional obstructive sleep apnea in children: a pilot study

Lena Xiao1, Adele Baker2, Giorge Voutsas1

  • 1Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.

Sleep Medicine
|August 16, 2021
PubMed

Insights

Positional obstructive sleep apnea (POSA) in children can be effectively treated with a positional device, a non-invasive therapy that prevents supine sleeping. This treatment offers a promising alternative for children who cannot tolerate continuous positive airway pressure.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Medicine
  • Biomedical Engineering

Background:

  • Obstructive sleep apnea (OSA) in children poses a challenge, especially for those intolerant to continuous positive airway pressure (CPAP).
  • Positional OSA (POSA), where OSA predominantly occurs in the supine position, is a common phenotype.
  • Effective interventions for POSA in children are lacking, highlighting a critical research gap.

Purpose of the Study:

  • To evaluate the efficacy of a positional device as a treatment for POSA in children.
  • To assess the impact of positional therapy on the obstructive apnea-hypopnea index (OAHI) in pediatric patients.

Main Methods:

  • An observational study involving children aged 4-18 years diagnosed with POSA.
  • Baseline polysomnography (PSG) followed by a second PSG while using a positional device.
  • Primary outcome measured was the change in OAHI.

Main Results:

  • Positional device therapy significantly reduced the median OAHI from 15.2 to 6.7 events/hour (p=0.004).
  • The percentage of total sleep time in the supine position decreased significantly from 54.4% to 4.2% (p=0.04).
  • Improvements in oxygen desaturation index were observed but not statistically significant.

Conclusions:

  • Positional device therapy is an effective treatment for POSA in children.
  • This therapy presents a potential cost-efficient and non-invasive clinical option for managing pediatric POSA.
Abstract

Keywords:
PediatricsPositional device therapySleep-disordered breathingTreatment

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