Polygraphic respiratory events during sleep in children treated with home continuous positive airway pressure: description and clinical consequences.

Abstract

OBJECTIVE:

Data are scarce on respiratory events during sleep for children treated at home with continuous positive airway pressure (CPAP). The present study aimed to characterize the respiratory events with CPAP during sleep and to analyze their clinical consequences.

PATIENTS/METHODS:

Consecutive polygraphies (PG) performed on stable children treated with CPAP were analyzed and scored using SomnoNIV Group definitions. For every respiratory event, the presence of a 3% oxygen desaturation and/or an autonomic arousal was systematically searched. Nocturnal gas exchange was assessed using summary data of oximetry and transcutaneous carbon dioxide pressure recordings.

RESULTS:

Twenty-nine consecutive polygraphies, performed on 26 children (mean age 7.8 ± 6.2 years, mean CPAP use 10.6 ± 14.4 months), were analyzed. The index of total respiratory events was low (median value 1.4/h, range 0-34). The mean number of different types of respiratory events per PG was 2 ± 1 (range 0-4), with always a predominant event. Partial or total upper airway obstruction without a decrease in ventilatory drive was the most frequent event and was the most frequently associated with an oxygen desaturation (in 30% of the events) and an autonomic arousal (in 55% of the events). Weak correlations were observed between nocturnal oximetry and PG results.

CONCLUSIONS:

The index of respiratory events during CPAP treatment for stable children is low. As these events may be associated with an oxygen desaturation or an autonomic arousal, and as nocturnal gas exchange cannot predict PG results, a systematic sleep study seems justified for the routine follow-up of children treated with CPAP.

• Authors: Alessandro Amaddeo, Valeria Caldarelli, Marta Fernandez-Bolanos, Johan Moreau, Adriana Ramirez, Sonia Khirani, Brigitte Fauroux
• Journal: Sleep medicine (Sleep Med) Vol. 16 Issue 1 Pg. 107-12 (Jan 2015) ISSN: 1878-5506 [Electronic] Netherlands
• PMID: 25541022 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Airway Resistance (physiology)
• Arousal (physiology)
• Child
• Child, Preschool
• Continuous Positive Airway Pressure
• Female
• Humans
• Infant
• Male
• Oximetry
• Polysomnography
• Pulmonary Gas Exchange (physiology)
• Respiratory Mechanics (physiology)
• Sleep Apnea, Obstructive (diagnosis, physiopathology, therapy)