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- Title
Obstructive Sleep Apnea and Sleep Position: Does It Matter for Infants With a Cleft Palate?
- Authors
Greenlee, Christopher J.; Scholes, Melissa A.; Gao, Dexiang; Friedman, Norman R.
- Abstract
Objective: To determine whether nonsupine sleep improves obstructive sleep apnea (OSA) in infants with cleft palate undergoing polysomnography (PSG). Design: Retrospective chart review. Setting: Tertiary care pediatric hospital. Patients: Twenty-seven infants (1 month to 1 year) with cleft palate with or without cleft lip (CP ± L) undergoing PSG testing for suspected OSA were included. Main Outcome Measures: Polysomnography measures included obstructive apnea–hypopnea index (OAHI), central apnea–hypopnea index (CAHI), oxygen saturation (SpO2) nadir, SpO2, and end-tidal carbon dioxide (ETCO2). Results: Twenty-three PSGs with at least 20 minutes of sleep in both the supine and the nonsupine positions were analyzed. The supine OAHI (mean: 16.8 events/hour; standard deviation [SD]: 18.5) and nonsupine OAHI (mean: 12.6 events/hour; SD: 12.6) did not differ significantly (P =.10). The supine CAHI (mean: 1.9 events/hour; SD: 2.7) and nonsupine CAHI (mean: 3.1 events/hour; SD: 3.7; P =.15), the supine SpO2 nadir (mean: 81.2%; SD: 6.3) and nonsupine SpO2 nadir (mean: 81.8%; SD: 5.3; P =.70), the supine mean SpO2 (mean: 95.5%; SD: 1.9) and nonsupine mean SpO2 saturation (mean: 95.3%; SD: 2.4; P =.34), and the supine ETCO2 (mean: 45.4 mm Hg; SD: 5.3) and nonsupine ETCO2 (mean: 42.5 mm Hg; SD: 10.1; P =.24) were also similar. Conclusions: There were no significant improvements in OSA metrics during nonsupine sleep in infants with CP ± L. Prior to recommending nonsupine positioning which increases infant's exposure to sudden infant death syndrome risk, we advocate obtaining a PSG to verify an objective improvement in OSA.
- Subjects
INFANT mortality; REACTIVE oxygen species; CAPNOGRAPHY; CHILDREN'S hospitals; CLEFT lip; CLEFT palate; MEDICAL records; OXYGEN in the body; SLEEP apnea syndromes; SUPINE position; POLYSOMNOGRAPHY; RETROSPECTIVE studies; ACQUISITION of data methodology; TERTIARY care; MORTALITY risk factors
- Publication
Cleft Palate Craniofacial Journal, 2019, Vol 56, Issue 7, p890
- ISSN
1055-6656
- Publication type
Article
- DOI
10.1177/1055665618817664