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Prematurity and obstructive sleep apnea in children: The perfect storm

Oscar Camilo Pantoja-Gomez1, Juanita Agudelo-Agudelo1, Elida Duenas-Meza1

  • 1Universidad de La Sabana, Colombia; Fundación Neumológica Colombiana, Colombia.

Paediatric Respiratory Reviews
|July 11, 2025
PubMed

Insights

Premature infants have a higher risk of obstructive sleep apnea (OSA) due to physiological factors. Early identification and tailored treatments are crucial for improving outcomes in these vulnerable children.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Sleep Medicine

Background:

  • Improving survival rates in premature infants necessitates understanding associated health risks.
  • Premature infants face a significantly increased risk of obstructive sleep apnea (OSA).
  • Anatomical and physiological factors unique to prematurity contribute to OSA development.

Purpose of the Study:

  • To explore the link between prematurity and obstructive sleep apnea (OSA).
  • To summarize shared pathophysiological mechanisms.
  • To emphasize the importance of identifying OSA in premature infants.

Main Methods:

  • Review of current literature on prematurity and OSA.
  • Analysis of anatomical and physiological factors contributing to OSA in premature infants.
  • Discussion of polysomnographic assessments and ventilatory responses.

Main Results:

  • Premature infants exhibit a threefold increased risk of OSA.
  • Factors include abnormal upper airway, unstable ventilation, bronchopulmonary dysplasia, and infections.
  • Multisystemic effects of prematurity exacerbate OSA outcomes, including neurodevelopmental deficits and pulmonary hypertension.

Conclusions:

  • A "Perfect Storm" exists for premature infants with OSA.
  • Identifying and characterizing OSA in all premature infants is essential.
  • Personalized oxygen saturation targets based on individual physiology are recommended over generalized protocols.

Keywords:
Obstructive sleep apneaOutcomesOxygenationPathophysiologyPrematurity

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