SLEEP-DISORDERED BREATHING IN INFANTS: ROLE OF PSG AND COMORBID CONDITIONS

Abstract

TOPIC: Sleep Disorders TYPE: Original Investigations PURPOSE: To investigate the common indications for polysomnogram (PSG), associated comorbidities, and treatment options for management of sleep-disordered breathing (SDB) in infants. METHODS: This was a single center, retrospective study that included infants (age <12 months) who underwent PSG for evaluation of SDB at the University of Louisville and Norton Medical Group Pediatric Sleep Disorders Clinic from July 2012 to September 2020. SDB severity was categorized by apnea-hypopnea index (AHI): mild = 1–4.9 events/hour; moderate = 5–9.9 events/hour; severe ≥ 10 events/hour. RESULTS: A total of 101 infants who underwent PSG for evaluation of SDB were included in the study. The mean age was 6.9±3.5 months, 52.5% were male, and 73.3% were Caucasians. The most common indication for PSG was snoring 73.3% (74/101) followed by apneas 44.6% (45/101). Associated comorbid conditions included gastro-esophageal reflux (38.6%), craniofacial abnormalities (18.8%), prematurity (17.8%), and laryngomalacia (15.8%). Mean total sleep time was 400.6±82.8; the mean AHI was 9.9±17.4, obstructive apnea-hypopnea index (OAHI) was 6.8±12.8, SaO2 nadir was 85.5±8.6, mean SaO2 was 96.9±9.1, and mean EtCO2 was 40.5±7.4. The overall AHI was normal in 14.9%, mild in 36.6%, moderate in 10.9%, and severe in 14.9% of the included infants. OAHI was mild in 36.6%, moderate in 10.9%, and severe in 14.7% of the infants included in the study. Central apnea index was >1 events/hour in 53.5% of the infants. Oxygen supplement was used in 12.1%, gastro-esophageal reflux treatment was given in 13.1%, and 29.1% had surgical intervention. CONCLUSIONS: PSG is a valuable tool in the diagnosis of SDB in infants and may help guide timely and appropriate evaluation and interventions. Comorbidities of SDB in infants differ from associated comorbidities in older children. CLINICAL IMPLICATIONS: Infants with the reported comorbidities can benefit from screening for SDB. Management of SDB in these infants require a multidisciplinary approach given the range of the associated comorbid conditions. DISCLOSURES: Speaker/Speaker's Bureau relationship with United therapeutics Please note: $5001 - $20000 by Karim El-Kersh, source=Web Response, value=Honoraria Removed 04/21/2021 by Karim El-Kersh, source=Web Response Advisory Committee Member relationship with United therapeutics Please note: $1001 - $5000 by Karim El-Kersh, source=Web Response, value=Consulting fee Removed 04/21/2021 by Karim El-Kersh, source=Web Response Advisory Committee Member relationship with Actelion Please note: $5001 - $20000 by Karim El-Kersh, source=Web Response, value=Consulting fee Removed 04/21/2021 by Karim El-Kersh, source=Web Response Advisory Committee Member relationship with United Therapeutics Please note: Current Added 04/23/2021 by Karim El-Kersh, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Actelion Please note: 2019 and 2020 Added 04/23/2021 by Karim El-Kersh, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with United Therapeutics Please note: Current Added 04/29/2021 by Karim El-Kersh, source=Web Response, value=Honoraria Advisory Committee Member relationship with United Therapeutics Please note: Current Added 04/29/2021 by Karim El-Kersh, source=Web Response, value=Honoraria Advisory Committee Member relationship with Actelion Please note: 2019 and 2020 Added 04/29/2021 by Karim El-Kersh, source=Web Response, value=Honoraria Consultant relationship with Acceleron Pharma Please note: Current Added 04/29/2021 by Karim El-Kersh, source=Web Response, value=Consulting fee No relevant relationships by Quang Nguyen, source=Web Response No relevant relationships by Egambaram Senthilvel, source=Web Response