If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Infants With Obstructive Sleep Apnea Treated Successfully At Home NORTHBROOK, IL -- July 13, 1999 -- Infants with obstructive sleep apnea (OSA) can be safely and effectively treated at home for a considerable period of time with a nose mask through which continuous positive airway pressure is provided, according to a new study. Researchers from the University of Sydney in Australia reported their findings in this month’s issue of the journal CHEST. OSA, the most common type of sleep apnea, occurs when the throat muscles and tongue relax during breathing and partially block the opening of the airway. So-called central apnea is more prevalent in infants and is believed to be associated with immaturity of the central nervous system. The more serious OSA is relatively rare in infants and is sometimes implicated in sudden infant death syndrome (SIDS). Nasal continuous positive airway passage (nCPAP) is the most common effective treatment for sleep apnea. The patient wears a mask over the nose during sleep and pressure from an air compressor forces air through the nasal passages. The air pressure is adjusted so that it is just enough to hold the throat open when it relaxes the most. The major disadvantage of nCPAP is that about 40 percent of patients have difficulty using it for a long period of time. Facial skin irritation, drying of the nose, abdominal bloating and sore eyes are among the side effects reported. Although nCPAP has been demonstrated to be effective in treating OSA in infants, Frances McNamara, PhD, and colleagues at the University of Sydney’s David Read Laboratory wanted to determine the effectiveness of long-term nCPAP therapy in infants at home. They also wanted to see if nCPAP could be considered as an alternative to other treatments, including surgery. And, they wanted to learn the effects of increasing age and development on both OSA severity and the requirements for specific levels of nCPAP. Twenty-four infants with OSA participated in the study. They had clinical histories that included a family history of SIDS, an apparent life threatening event (ALTE), or facial and upper airway anatomic abnormalities. Researchers reported that 18 of the infants were treated successfully with nCPAP in their home for a period of from one to four years. They noted that five of the infants, each of whom had conditions that involved anatomic abnormalities, received continued nCPAP therapy because repeated diagnostic polysomnographic studies showed persistent obstructive apnea during sleep. In nine infants, obstructive events were completely abolished. The authors said that, in general, infants tolerated the CPAP and the nasal mask very well. There were no problems reported by parents concerning the CPAP pressure or the mask itself. There were no reports of any facial skin breakdown or skeletal changes in any of the infants during treatment. It was also reported that nCPAP therapy caused increased daytime alertness in each infant. Researchers found that a significantly higher CPAP was required to prevent obstructive events during sleep as each infant grew older, but sleep-disordered breathing in many of the study infants improved with age. The researchers concluded that nCPAP therapy was shown to be effective in the management of OSA in infants, regardless of the believed site and mechanism of obstruction. They added that nCPAP is effective as a short-term treatment for infants who have OSA for a transient period of time and it is effective as a long-term treatment for infants with facial and upper airway anatomic abnormalities. They also noted that nCPAP was a safe alternative to the placement of a nasopharyngeal airway or surgery and it served as a temporary treatment for infants who would eventually require surgery. "Our findings stress the need for regular follow-up because the amount of OSA and the level of nCPAP needed to prevent obstructive apnea often change with age and development," Dr. McNamara said.
|
