1103 Effective CPAP Treatment is Associated with Catch Up Growth in Infants with Obstructive Sleep Apnea and Failure to Thrive. (27th April 2018)

• Record Type: Journal Article
• Authors: Wang, Grace; Rao, Harish
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A410
• Page End: A410
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy063.1102
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Obstructive sleep apnea (OSA) in children is associated with transient airway obstruction, hypoxemia, and increased caloric expenditure, likely from increased work of breathing (WOB). We describe three infants with OSA and failure to thrive (FTT), who demonstrated catch up growth after effective treatment with CPAP. Report of Cases: Patient #1: Diagnosed with moderate laryngomalacia and severe OSA (AHI 185 events/hour), CPAP of 9 cm H2O was well established at 7 months of age. Weight and length increased from < 2nd to 69th percentile and from <5th to 25th percentile at 12 months respectively. Patient #2: Diagnosed with DiGeorge Syndrome and tracheobronchomalacia and presented at two months with severe OSA (AHI 26 events/hour with SpO2 nadir 79%). Initiation of CPAP (11 cm H2O) improved weight gain from 0-2nd to 14th by 5 months and 35-45th percentile by 8 months. Patient #3: Diagnosed with skeletal dysplasia, tracheobronchomalacia, aspiration, and gastroesophageal reflux presented with moderate OSA (AHI of 5.1 events per hour with SpO2 nadir 78%) at 5 months. With CPAP (6 cm H2O) his weight increased from 20-30th percentile to 50-70th percentiles at 10 months. Conclusion: CPAP has been shown to decrease WOB by splinting open the airway, increasing end-expiratory lung volume, reducing thoraco-abdominal asynchrony with potential for reduced caloric expenditure during sleep resulting in weight gain. While WOB was not directly measured in this case series all patients' showed improvement of OSA after CPAP. The patients' diets and caloric intake remained unchanged during this period. Our observations mirror prior studies, where children showed improved somatic growth parameters after treatment of OSA with adenotonsillectomy. To our knowledge, this is the first case series that addresses effective CPAP therapy and its potential to decrease WOB and ameliorate weight gain in infants with OSA and failure to thrive.