The maturation changes of sleep-related respiratory abnormalities in infants with laryngomalacia

Ratanakorn, Woranart; Brockbank, Justin; Ishman, Stacey L.; Tadesse, Dawit G.; Hossain, Monir; Simakajornboon, Narong

doi:10.5664/jcsm.9046

Cited by 14 publications

(12 citation statements)

References 39 publications

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“…In the current study, we focused on infants in whom the appearance of OSA was unexpected, based on infants' general appearance or facial structure. In syndromes such as PRS or laryngomalacia, the natural course of OSA is likely to be specific to the syndrome or defect 2,4 …”

Section: Discussionmentioning

confidence: 99%

“…In syndromes such as PRS or laryngomalacia, the natural course of OSA is likely to be specific to the syndrome or defect. 2,4 We suggest that the reason for a decreased tendency toward upper airway obstruction by age may be in part be due to the stiffening of epiglottal and laryngeal structures or to the disappearance of GERD-related upper airway mucosal swallowing. 6,29 We do not suppose that any of the treatment provided would have had a significant effect on natural improvement of OSA.…”

Section: Natural Evolution Of Upper Airway Obstruction In Infantsmentioning

confidence: 92%

“…20 In laryngomalacia, the recovery may be slower, occurring gradually by the age of 3 years. 4 OSA in infants with previous ALTE usually resolves by the age of 6−12 months. 21 Here, we focused on the natural evolution of upper airway obstruction in infants less than 3 months of age without either syndromes, genetic defects, structural anomalies, or a predominant central breathing disorder.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, in other patient groups with a clear anatomical predisposal to OSA, improvement of OSA often occurs by the age of 8 months 20 . In laryngomalacia, the recovery may be slower, occurring gradually by the age of 3 years 4 . OSA in infants with previous ALTE usually resolves by the age of 6−12 months 21 …”

Section: Introductionmentioning

confidence: 99%

“…Infants commonly show single obstructive events during sleep, whereas repetitive obstructive events are rare. 1 OSA is common in infants with upper airway anomalies such as Pierre Robin sequence (PRS) 2 or laryngomalacia, 3,4 but OSA may also appear without any noticeable anatomical predisposal, 5 especially in infants with gastroesophageal reflux (GERD), 6,7 in premature infants, 3,[8][9][10] infants with previous brief, resolved unexplained event (BRUE) or an apparent life-threatening event (ALTE), [11][12][13][14] or in infants who subsequently succumb to sudden infant death syndrome (SIDS). 15 OSA in infants is often sleepposition dependent, and is more severe in the supine than in the sideor prone sleeping position.…”

Section: Introductionmentioning

confidence: 99%

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Obstructive sleep apnea in young infants: Sleep position dependence and spontaneous improvement

Kukkola

Kirjavainen

2022

Pediatric Pulmonology

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Objectives The natural evolution of obstructive sleep apnea (OSA) in young infants is not established. Methods We re‐evaluated 10‐year pediatric sleep center infant polysomnography (PSG) data, excluding infants with syndromes, genetic defects, structural anomalies or periodic breathing > 5% of sleep time. Results Obstructive events > 1 h‐1 were evident in 255 infants, of which 91 were eligible for the study. Of the 38 infants in a follow‐up study, 30 (79%) were male, 15 (40%) were born prematurely, 25 (66%) had observed apneas, and 13 (33%) had experienced a brief, unexplained event or had a sibling of the infant died suddenly. The first PSG was performed at a median corrected age of 4 weeks (interquartile range [IQR] 2−7) and the second at 11 weeks (IQR 9−14). The obstructive apnea and hypopnea index (OAHI) was greater in the supine compared to side‐sleeping position in both recordings (p < 0.001), whereas OAHI dropped from 10 h‐1 (IQR 6−24) in the first PSG to 3 h‐1 (IQR 1−9) in the second PSG (p < 0.001). OSA alleviation was also observable as a decrease in the number of oxygen desaturations (p < 0.001), as a decrease in transcutaneous (p = 0.001) and end‐tidal carbon dioxide (p = 0.01) 95th percentile levels, and work of breathing (p = 0.002). Seven infants had a third PSG to verify a satisfactory improvement of OSA. Conclusions OSA in young infants without a clear syndrome or structural anomaly is sleep position dependent and shows improvement during the following few months.

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Section: Discussionmentioning

confidence: 99%