Obstructive Sleep Apnea in Neonates

Abstract

Neonates have distinctive anatomic and physiologic features that predispose them to obstructive sleep apnea (OSA). The overall prevalence of neonatal OSA is unknown, although an increase in prevalence has been reported in neonates with craniofacial malformations, neurological disorders, and airway malformations. If remained unrecognized and untreated, neonatal OSA can lead to impaired growth and development, cardiovascular morbidity, and can even be life threatening. Polysomnography and direct visualization of the airway are essential diagnostic modalities in neonatal OSA. Treatment of neonatal OSA is based on the severity of OSA and associated co-morbidities. This may include medical and surgical interventions individualized for the affected neonate. Based on this, it is expected that infants with OSA have more significant healthcare utilization.

Sleep Studies for Clinical Indications during the First Year of Life: Infants Are Not Small Children

“…Even healthy young infants are predisposed to upper airway obstruction and hypoxemia both during sleep and wakefulness as a result of increased upper airway and chest wall compliance and immature control of breathing [2]. Chandrasekar et al, have recently reviewed the etiology, clinical manifestations, and treatment of obstructive sleep apnea syndrome (OSAS) in neonates, and have identified an obstructive apnea-hypopnea index (AHI) > 1 episode/h in PSG as the cut-off value for OSAS diagnosis [3]. However, this OSAS diagnostic threshold value of obstructive AHI has been a matter of discussion and contention in everyday clinical practice.…”

Diagnostik und Therapie der obstruktiven Schlafapnoe im Säuglingsalter am Beispiel der Robin-Sequenz

“…Risikofaktoren für ein OSAS im Säuglingsalter [4,5]. Eine systematische Auflistung der Risikogruppen finden Sie in ▶ Tab.…”

“…Klinisch präsentiert sich ein OSAS bei Säuglingen äußerst variabel und deutlich subtiler. Während bei älteren Kindern regelmäßiges und lautes Schnarchen, Tagesschläfrigkeit und Verhaltensauffälligkeiten Leitsymptome für ein OSAS darstellen, ergeben sich bei Säuglingen Hinweise durch einen unruhigen Schlaf mit häufigen Weckreaktionen, Kopfreklination, Trinkschwäche, Gedeihstörung, Reflux, Stridor, Schnarchen, laute Atemgeräusche, sehr lange Schlafepisoden, Tachypnoe, Einziehungen und Kopfnicken als Zeichen einer erhöhten Atemarbeit sowie Beobachtung von Atempausen [5]. Als Cut-off für das Vorliegen eines OSAS gelten wie bei älteren Kindern eine oder mehrere obstruktive Apnoen oder Hypopnoen pro Stunde [9].…”

Current Concepts in Pediatric Obstructive Sleep Apnea

“…Clinically, the association of OSA with asthma and hepatic steatosis in children and adolescents is reported here [ 4 , 5 ]. OSA in high-risk populations such as Down syndrome, neonates, and children with attention deficit hyperactivity disorder are also addressed in this special edition [ 6 , 7 , 8 , 9 ].…”

“…Neonates have distinctive anatomic and physiologic features that predispose them to have OSA compared to older children and adults. OSA is most commonly caused by airway abnormalities extending from the nose to the larynx mainly related to craniofacial malformations, neuromuscular disorders, and prematurity in neonates [ 7 ]. In young healthy children, the main etiology of OSA is related to adenoid and/or tonsillar hypertrophy [ 10 ].…”