Effects of overnight supplemental oxygen in obstructive sleep apnea in children.

Abstract

Supplemental oxygen during sleep may be useful as a temporary palliative treatment in children with obstructive sleep apnea syndrome (OSAS) associated with significant hypoxemia. However, supplemental O2 may also blunt hypoxic ventilatory drive and worsen ventilation. To assess the safety of the use of supplemental O2 in children with OSAS, we studied 16 children ages 2-8 (mean: 4.28 +/- 2.88 yr) with OSAS secondary to adenotonsillar hypertrophy. Patients underwent two overnight polysomnograms within 1 mo, one on room air (RA) and one while receiving supplemental O2 via nasal cannula titrated by 1/4 lpm increments to achieve SpO2 > 95% during the first hour of sleep. Oxygenation measurements were significantly improved during supplemental O2 nights (average SpO2 increased from 89.5 +/- 4.8% on RA to 97.7 +/- 1.8% on supplemental O2 [p < 0.00001]) while alveolar ventilation remained unchanged (PETCO2 > 50 mm Hg: 3.6 +/- 8.9% total sleep time on RA and 3.3 +/- 6.3% total sleep time on supplemental O2 [p = NS]). Supplemental O2 significantly reduced hypopnea density, obstructive apnea index, and paradoxical breathing. The density and average duration of central apneas remained unchanged. In addition, supplemental O2 increased the percentage of REM sleep time and decreased the number of microarousals. We conclude that supplemental O2 might be a safe and beneficial temporary treatment in children with OSAS.

Sleep-disordered breathing, behavior, and academic performance in Taiwan schoolchildren

“…In our study, children with severe SDB also scored significantly lower than the other children with less severity on the attention domain. One possible cause was that SDB leads to decreased arterial blood oxygen saturation, and results in hypoxemia in the brain [41]. A potentially serious consequence of intermittent hypoxia during sleep might involve its long-term effects on neuronal function [42].…”

Psychiatric disorders and symptoms severity in patients with adenotonsillar hypertrophy before and after adenotonsillectomy

“…In the current study, the significant highness of preoperative psychiatric disorders and symptoms in patients who were decided with surgery indication as a result of the parent anamnesis and physical examination and similar levels of these symptoms and disorders with those of the control group in the postoperative month six, support the aforementioned data. Because previous studies reported that more than half of patients with an indication of adenotonsillectomy based on anamnesis and a physical examination had OSA(À) (31-54%) [55][56][57]. Our patient group consisted of preschool children aged three to five years.…”

De ‘Richtlijn OSAS bij kinderen’

“…Er is weinig bekend over de mechanismen waarop zuurstoftherapie bij OSAS werkzaam is en er bestaat onduidelijkheid over de effectiviteit van de behandeling. De behandeling leidt wel tot een zuurstofstijging in het bloed, maar verlaagt de AHI niet of nauwelijks Aljadeff et al, 1996).…”