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A Randomized Crossover Trial to Evaluate the Effect of Positioning on Obstructive Sleep Apnea in Infants with Robin

Cornelia Wiechers1,2, Simon Goetz1, Karen Kreutzer1,2

  • 1Department of Neonatology, Tuebingen University Hospital, Calwerstrasse 7, 72076 Tuebingen, Germany.

Children (Basel, Switzerland)
|March 28, 2025
PubMed

Insights

Prone positioning may help infants with Robin sequence (RS) obstructive sleep apnea (OSA), but it doesn't always work and can sometimes worsen symptoms. Further research is needed for optimal infant sleep positioning.

Area of Science:

  • Pediatric Sleep Medicine
  • Neonatology
  • Craniofacial Anomalies

Background:

  • Robin sequence (RS) infants often experience obstructive sleep apnea (OSA).
  • Prone positioning is a common intervention for RS OSA, but its efficacy and safety are debated.
  • Concerns exist regarding the increased risk of sudden infant death syndrome (SIDS) with prone positioning.

Purpose of the Study:

  • To investigate the effects of prone versus supine sleep positioning on OSA in infants with RS.
  • To analyze key polysomnographic parameters in both sleep positions.

Main Methods:

  • Prospective randomized crossover study design.
  • Polygraphy was used to assess obstructive apnea index (OAI), oxygen desaturation, and respiratory parameters.
  • Infants with RS admitted to a university hospital were analyzed.

Main Results:

  • No significant difference in OAI between supine and prone positions in main analyses.
  • Unadjusted analysis suggested a higher OAI in the supine position.
  • 13/21 infants showed improvement with prone positioning, while 8/21 experienced worsening OSA.

Conclusions:

  • Prone positioning can improve OSA symptoms in infants with RS, but does not eliminate them.
  • Severe OSA may persist despite prone positioning.
  • A subset of infants may experience worsened OSA when placed in the prone position.
Abstract

Keywords:
Robin sequenceinfantobstructive sleep apneaprone positionsupine position

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