Intranasal corticosteroids for mild childhood obstructive sleep apnea – a randomized, placebo-controlled study

Abstract

BackgroundThe use of non-surgical treatment for childhood obstructive sleep apnea (OSA) is gaining popularity, especially in children with mild disease. ObjectiveTo test the hypothesis that intranasal corticosteroids reduce disease severity in children with mild OSA. Study designA randomized, double-blinded, placebo-controlled trial of intranasal mometasone furoate (MF) versus placebo in children aged 6 to 18 years with mild OSA. The primary outcome was the change from baseline obstructive apnea hypopnea index (OAHI), as documented by overnight polysomnography, after four months of treatment. ResultsSixty-two children were recruited but 12 dropped out. This left 24 and 26 children for final analysis in the MF and placebo group, respectively. The OAHI and oxygen desaturation index (ODI) improved significantly in the MF group only. The OAHI decreased from 2.7 ± 0.2 to 1.7 ± 0.3 in the MF group, but increased from 2.5 ± 0.2 to 2.9 ± 0.6 in the placebo group (p = 0.039). The mean changes in ODI in the MF group and placebo group were −0.6 ± 0.5 and +0.7 ± 0.4, respectively (p = 0.037). ConclusionFour months of treatment with intranasal mometasone furoate effectively reduces the severity of mild OSA in children.