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Treatment of obstructive sleep apnoea using nasal CPAP in children with craniofacial dysostoses
S Gonsalez1, D Thompson, R Hayward
1Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, Institute of Child Health, London, UK.
Insights
Nasal continuous positive airway pressure (n-CPAP) effectively treated obstructive sleep apnea in children with craniofacial dysostosis. This study shows n-CPAP is a viable palliative option for these young patients.
Area of Science:
- Pediatric Pulmonology
- Craniofacial Medicine
- Sleep Medicine
Background:
- Children with craniofacial dysostosis often experience obstructive sleep apnea (OSA).
- OSA in this population can lead to significant respiratory compromise.
- Effective palliative treatments for pediatric OSA associated with craniofacial syndromes are needed.
Purpose of the Study:
- To evaluate the efficacy and tolerance of nasal continuous positive airway pressure (n-CPAP) as a palliative treatment for OSA in children with craniofacial dysostosis.
- To assess the clinical and polygraphic improvements associated with n-CPAP therapy.
Main Methods:
- A cohort of children (aged 2.2-15 years) with craniofacial dysostosis and OSA were enrolled.
- Patients underwent an acclimatization period to n-CPAP, followed by a CPAP trial.
- Respiratory sleep studies were conducted to assess baseline breathing difficulty and n-CPAP effectiveness.
Main Results:
- n-CPAP was successful in 5 out of 8 patients, demonstrating immediate clinical and polygraphic improvements.
- One patient required extended acclimatization, one withdrew, and one failed to respond due to enlarged adenoids.
- The treatment was generally well-tolerated by the young patient group.
Conclusions:
- n-CPAP is a tolerable and effective palliative treatment for obstructive sleep apnea in children with craniofacial syndromes.
- Early intervention with n-CPAP can significantly improve respiratory patterns in this vulnerable population.
- Further research may explore optimizing n-CPAP protocols for children with complex craniofacial anomalies.
Abstract:
We studied a group of children (aged 2.2-15 years) with craniofacial dysostosis and obstructive sleep apnoea to assess the use of nasal continuous positive airway pressure (n-CPAP) as a palliative form of treatment. A variable period of time was allowed for acclimatisation to n-CPAP (1 day to 2 months), depending on the patient. Patients were then admitted for their first CPAP trial. Baseline breathing difficulty and the effectiveness of n-CPAP were assessed by respiratory sleep studies. Successful results were obtained with n-CPAP in five of the eight patients, with marked clinical and polygraphic improvements of the respiratory pattern immediately after n-CPAP was established. Of the remaining three cases, one child needed a prolonged period of acclimatisation to the n-CPAP system, one was withdrawn from the study, and one failed to respond to n-CPAP and was found to have complete blockage of the upper airways as a result of enlarged adenoids. Our results confirm that n-CPAP can be tolerated even by young patients and can be effective, and that it may be a useful alternative palliative treatment for obstructive sleep apnoea in children with craniofacial syndromes.