Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea
Abstract
:1. Introduction
2. Diagnosing Obstructive Sleep Apnea
3. Deciding to Use Positive Airway Pressure
4. What Is Positive Airway Pressure?
5. Preparing for PAP Initiation
6. Choosing the Right Pressures/Settings
7. Monitoring Patients after PAP Initiation
8. Positive Airway Pressure Adherence
9. Auto-Titration CPAP in Pediatric Patients
10. Positive Airway Pressure Cessation
11. In Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- American Academy of Sleep Medicine. International Classification of Sleep Disorders—Third Edition (ICSD-3); American Academy of Sleep Medicine: Darien, IL, USA, 2014. [Google Scholar]
- Marcus, C.L.; Keens, T.G.; Bautista, D.B.; von Pechmann, W.S.; Ward, S.L. Obstructive Sleep Apnea in Children with Down Syndrome. Pediatrics 1991, 88, 132–139. [Google Scholar]
- Lin, H.-Y.; Lin, S.-P.; Lin, C.-C.; Tsai, L.-P.; Chen, M.-R.; Chuang, C.-K.; Huang, C.-Y. Polysomnographic Characteristics in Patients with Prader-Willi Syndrome. Pediatr. Pulmonol. 2007, 42, 881–887. [Google Scholar] [CrossRef]
- Anderson, I.C.W.; Sedaghat, A.R.; McGinley, B.M.; Redett, R.J.; Boss, E.F.; Ishman, S.L. Prevalence and Severity of Obstructive Sleep Apnea and Snoring in Infants with Pierre Robin Sequence. Cleft Palate Craniofac. J. 2011, 48, 614–618. [Google Scholar] [CrossRef]
- Capdevila, O.S.; Kheirandish-Gozal, L.; Dayyat, E.; Gozal, D. Pediatric Obstructive Sleep Apnea: Complications, Management, and Long-Term Outcomes. Proc. Am. Thorac. Soc. 2008, 5, 274–282. [Google Scholar] [CrossRef]
- Guilleminault, C.; Lee, J.H.; Chan, A. Pediatric Obstructive Sleep Apnea Syndrome. Arch. Pediatr. Adolesc. Med. 2005, 159, 775–785. [Google Scholar] [CrossRef] [PubMed]
- Marcus, C.L.; Brooks, L.J.; Draper, K.A.; Gozal, D.; Halbower, A.C.; Jones, J.; Schechter, M.S.; Sheldon, S.H.; Spruyt, K.; Ward, S.D.; et al. Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics 2012, 130, 576–584. [Google Scholar] [CrossRef] [Green Version]
- Ismail, K.; Roberts, K.; Manning, P.; Manley, C.; Hill, N.S. OSA and Pulmonary Hypertension: Time for a New Look. Chest 2015, 147, 847–861. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lattimore, J.-D.L.; Wilcox, I.; Adams, M.R.; Kilian, J.G.; Celermajer, D.S. Treatment of Obstructive Sleep Apnoea Leads to Enhanced Pulmonary Vascular Nitric Oxide Release. Int. J. Cardiol. 2008, 126, 229–233. [Google Scholar] [CrossRef] [PubMed]
- Chamness, J.A. Taking a Pediatric Sleep History. Pediatr. Ann. 2008, 37, 502–508. [Google Scholar] [CrossRef]
- Goldstein, N.A.; Abramowitz, T.; Weedon, J.; Koliskor, B.; Turner, S.; Taioli, E. Racial/ethnic Differences in the Prevalence of Snoring and Sleep Disordered Breathing in Young Children. J. Clin. Sleep Med. 2011, 7, 163–171. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Norman, M.B.; Harrison, H.C.; Waters, K.A.; Sullivan, C.E. Snoring and Stertor Are Associated with More Sleep Disturbance than Apneas and Hypopneas in Pediatric SDB. Sleep Breath. 2019, 23, 1245–1254. [Google Scholar] [CrossRef] [PubMed]
- Wang, R.C.; Elkins, T.P.; Keech, D.; Wauquier, A.; Hubbard, D. Accuracy of Clinical Evaluation in Pediatric Obstructive Sleep Apnea. Otolaryngol. Head Neck Surg. 1998, 118, 69–73. [Google Scholar] [CrossRef]
- Withers, A.; Maul, J.; Rosenheim, E.; O’Donnell, A.; Wilson, A.; Stick, P.S. Comparison of Home Ambulatory Type 2 Polysomnography with a Portable Monitoring Device and in-Laboratory Type 1 Polysomnography for the Diagnosis of Obstructive Sleep Apnea in Children. J. Clin. Sleep Med. 2021. [Google Scholar] [CrossRef]
- Berry, R.B.; Quan, S.F.; Abreu, A.R.; Bibbs, M.L.; DelRosso, L.; Harding, S.M.; Mao, M.-M.; Plante, D.T.; Pressman, M.R.; Troester, M.M.; et al. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications; American Academy of Sleep Medicine: Darien, IL, USA, 2020. [Google Scholar]
- Beck, S.E.; Marcus, C.L. Pediatric Polysomnography. Sleep Med. Clin. 2009, 4, 393–406. [Google Scholar] [CrossRef] [Green Version]
- Kirk, V.; Baughn, J.; D’Andrea, L.; Friedman, N.; Galion, A.; Garetz, S.; Hassan, F.; Wrede, J.; Harrod, C.G.; Malhotra, R.K. American Academy of Sleep Medicine Position Paper for the Use of a Home Sleep Apnea Test for the Diagnosis of OSA in Children. J. Clin. Sleep Med. 2017, 13, 1199–1203. [Google Scholar] [CrossRef]
- Dehlink, E.; Tan, H.-L. Update on Paediatric Obstructive Sleep Apnoea. J. Thorac. Dis. 2016, 8, 224–235. [Google Scholar]
- Gipson, K.; Lu, M.; Kinane, T.B. Sleep-Disordered Breathing in Children. Pediatr. Rev. 2019, 40, 3–13. [Google Scholar] [CrossRef]
- Mitchell, M.; Werkhaven, J.A. Cost-Effectiveness of Polysomnography in the Management of Pediatric Obstructive Sleep Apnea. Int. J. Pediatr. Otorhinolaryngol. 2020, 133, 109943. [Google Scholar] [CrossRef] [PubMed]
- Prévost, A.-S.; Hylands, M.; Gervais, M.; Praud, J.-P.; Battista, M.-C.; Déziel-Malouin, S.; Lachance, M.; Lamontagne, F. Drug-Induced Sleep Endoscopy Compared with Systematic Adenotonsillectomy in the Management of Obstructive Sleep Apnoea in Children: A Systematic Review and Meta-Analysis Protocol. BMJ Open 2019, 9, e028242. [Google Scholar] [CrossRef] [PubMed]
- Nath, A.; Emani, J.; Suskind, D.L.; Baroody, F.M. Predictors of Persistent Sleep Apnea after Surgery in Children Younger than 3 Years. JAMA Otolaryngol. Head Neck Surg. 2013, 139, 1002–1008. [Google Scholar] [CrossRef] [Green Version]
- Bhattacharjee, R.; Kheirandish-Gozal, L.; Spruyt, K.; Mitchell, R.B.; Promchiarak, J.; Simakajornboon, N.; Kaditis, A.G.; Splaingard, D.; Splaingard, M.; Brooks, L.J.; et al. Adenotonsillectomy Outcomes in Treatment of Obstructive Sleep Apnea in Children: A Multicenter Retrospective Study. Am. J. Respir. Crit. Care Med. 2010, 182, 676–683. [Google Scholar] [CrossRef]
- Romero-Corral, A.; Caples, S.M.; Lopez-Jimenez, F.; Somers, V.K. Interactions between Obesity and Obstructive Sleep Apnea: Implications for Treatment. Chest 2010, 137, 711–719. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Harsch, I.A.; Schahin, S.P.; Radespiel-Tröger, M.; Weintz, O.; Jahreiss, H.; Fuchs, F.S.; Wiest, G.H.; Hahn, E.G.; Lohmann, T.; Konturek, P.C.; et al. Continuous Positive Airway Pressure Treatment Rapidly Improves Insulin Sensitivity in Patients with Obstructive Sleep Apnea Syndrome. Am. J. Respir. Crit. Care Med. 2004, 169, 156–162. [Google Scholar] [CrossRef] [PubMed]
- Katz, S.L.; Kirk, V.G.; MacLean, J.E.; Bendiak, G.N.; Harrison, M.-A.; Barrowman, N.; Hoey, L.; Horwood, L.; Hadjiyannakis, S.; Legault, L.; et al. Factors Related to Positive Airway Pressure Therapy Adherence in Children with Obesity and Sleep-Disordered Breathing. J. Clin. Sleep Med. 2020, 16, 733–741. [Google Scholar] [CrossRef] [PubMed]
- Katz, S.L.; MacLean, J.E.; Hoey, L.; Horwood, L.; Barrowman, N.; Foster, B.; Hadjiyannakis, S.; Legault, L.; Bendiak, G.N.; Kirk, V.G.; et al. Insulin Resistance and Hypertension in Obese Youth with Sleep-Disordered Breathing Treated with Positive Airway Pressure: A Prospective Multicenter Study. J. Clin. Sleep Med. 2017, 13, 1039–1047. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Marcus, C.L.; Radcliffe, J.; Konstantinopoulou, S.; Beck, S.E.; Cornaglia, M.A.; Traylor, J.; DiFeo, N.; Karamessinis, L.R.; Gallagher, P.R.; Meltzer, L.J. Effects of Positive Airway Pressure Therapy on Neurobehavioral Outcomes in Children with Obstructive Sleep Apnea. Am. J. Respir. Crit. Care Med. 2012, 185, 998–1003. [Google Scholar] [CrossRef]
- Johnstone, S.J.; Tardif, H.P.; Barry, R.J.; Sands, T. Nasal Bilevel Positive Airway Pressure Therapy in Children with a Sleep-Related Breathing Disorder and Attention-Deficit Hyperactivity Disorder: Effects on Electrophysiological Measures of Brain Function. Sleep Med. 2001, 2, 407–416. [Google Scholar] [CrossRef]
- Parmar, A.; Baker, A.; Narang, I. Positive Airway Pressure in Pediatric Obstructive Sleep Apnea. Paediatr. Respir. Rev. 2019, 31, 43–51. [Google Scholar] [CrossRef]
- Craig, T.J.; Teets, S.; Lehman, E.B.; Chinchilli, V.M.; Zwillich, C. Nasal Congestion Secondary to Allergic Rhinitis as a Cause of Sleep Disturbance and Daytime Fatigue and the Response to Topical Nasal Corticosteroids. J. Allergy Clin. Immunol. 1998, 101, 633–637. [Google Scholar] [CrossRef]
- Lee, S.-Y.; Guilleminault, C.; Chiu, H.-Y.; Sullivan, S.S. Mouth Breathing, “Nasal Disuse,” and Pediatric Sleep-Disordered Breathing. Sleep Breath. 2015, 19, 1257–1264. [Google Scholar] [CrossRef]
- Liming, B.J.; Ryan, M.; Mack, D.; Ahmad, I.; Camacho, M. Montelukast and Nasal Corticosteroids to Treat Pediatric Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis. Otolaryngol. Head Neck Surg. 2019, 160, 594–602. [Google Scholar] [CrossRef]
- Kheirandish-Gozal, L.; Bandla, H.P.R.; Gozal, D. Montelukast for Children with Obstructive Sleep Apnea: Results of a Double-Blind, Randomized, Placebo-Controlled Trial. Ann. ATS 2016, 13, 1736–1741. [Google Scholar] [CrossRef] [PubMed]
- Stupak, H.D.; Park, S.Y. Gravitational Forces, Negative Pressure and Facial Structure in the Genesis of Airway Dysfunction during Sleep: A Review of the Paradigm. Sleep Med. 2018, 51, 125–132. [Google Scholar] [CrossRef] [PubMed]
- Huang, Y.-S.; Guilleminault, C. Pediatric Obstructive Sleep Apnea and the Critical Role of Oral-Facial Growth: Evidences. Front. Neurol. 2012, 3, 184. [Google Scholar] [CrossRef] [Green Version]
- Guilleminault, C.; Huang, Y.-S. From Oral Facial Dysfunction to Dysmorphism and the Onset of Pediatric OSA. Sleep Med. Rev. 2018, 40, 203–214. [Google Scholar] [CrossRef] [PubMed]
- Aloia, M.S.; Arnedt, J.T.; Stanchina, M.; Millman, R.P. How Early in Treatment Is PAP Adherence Established? Revisiting Night-to-Night Variability. Behav. Sleep Med. 2007, 5, 229–240. [Google Scholar] [CrossRef]
- King, M.S.; Xanthopoulos, M.S.; Marcus, C.L. Improving Positive Airway Pressure Adherence in Children. Sleep Med. Clin. 2014, 9, 219–234. [Google Scholar] [CrossRef] [Green Version]
- Kirk, V.G.; O’Donnell, A.R. Continuous Positive Airway Pressure for Children: A Discussion on How to Maximize Compliance. Sleep Med. Rev. 2006, 10, 119–127. [Google Scholar] [CrossRef] [PubMed]
- Halbower, A.C. Continuous Positive Airway Pressure (CPAP) for Pediatric Obstructive Sleep Apnea. In UpToDate; Chervin, R.D., Eichler, A.F., Eds.; UpToDate: Waltham, MA, USA, 2020; (accessed on 13 September 2021). [Google Scholar]
- Koontz, K.L.; Slifer, K.J.; Cataldo, M.D.; Marcus, C.L. Improving Pediatric Compliance with Positive Airway Pressure Therapy: The Impact of Behavioral Intervention. Sleep 2003, 26, 1010–1015. [Google Scholar] [CrossRef] [Green Version]
- Dibra, M.N.; Berry, R.B.; Wagner, M.H. Treatment of Obstructive Sleep Apnea: Choosing the Best Interface. Sleep Med. Clin. 2017, 12, 543–549. [Google Scholar] [CrossRef] [PubMed]
- Villa, M.P.; Pagani, J.; Ambrosio, R.; Ronchetti, R.; Bernkopf, E. Mid-Face Hypoplasia after Long-Term Nasal Ventilation. Am. J. Respir. Crit. Care Med. 2002, 166, 1142–1143. [Google Scholar] [CrossRef]
- Roberts, S.D.; Kapadia, H.; Greenlee, G.; Chen, M.L. Midfacial and Dental Changes Associated with Nasal Positive Airway Pressure in Children with Obstructive Sleep Apnea and Craniofacial Conditions. J. Clin. Sleep Med. 2016, 12, 469–475. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bariani, R.C.B.; Guimarães, T.M.; Cappellette, M.; Moreira, G.; Fujita, R.R. The Impact of Positive Airway Pressure on Midface Growth: A Literature Review. Braz. J. Otorhinolaryngol. 2020, 86, 647–653. [Google Scholar] [CrossRef]
- Walter, L.M.; Dassanayake, D.U.N.; Weichard, A.J.; Davey, M.J.; Nixon, G.M.; Horne, R.S.C. Back to Sleep or Not: The Effect of the Supine Position on Pediatric OSA: Sleeping Position in Children with OSA. Sleep Med. 2017, 37, 151–159. [Google Scholar] [CrossRef] [PubMed]
- Tholen, K.; Meier, M.; Kloor, J.; Friedman, N. Persistent OSA in Obese Children: Does Body Position Matter? J. Clin. Sleep Med. 2021, 17, 227–232. [Google Scholar] [CrossRef] [PubMed]
- McSharry, D.G.; Saboisky, J.P.; Deyoung, P.; Jordan, A.S.; Trinder, J.; Smales, E.; Hess, L.; Chamberlin, N.L.; Malhotra, A. Physiological Mechanisms of Upper Airway Hypotonia during REM Sleep. Sleep 2014, 37, 561–569. [Google Scholar] [CrossRef] [Green Version]
- Kushida, C.A.; Chediak, A.; Berry, R.B.; Brown, L.K.; Gozal, D.; Iber, C.; Parthasarathy, S.; Quan, S.F.; Rowley, J.A.; Positive Airway Pressure Titration Task Force; et al. Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea. J. Clin. Sleep Med. 2008, 4, 157–171. [Google Scholar] [PubMed]
- Naik, S.; Al-Halawani, M.D.; Kreinin, I.; Kryger, M. Centers for Medicare and Medicaid Services Positive Airway Pressure Adherence Criteria May Limit Treatment to Many Medicare Beneficiaries. J. Clin. Sleep Med. 2019, 15, 245–251. [Google Scholar] [CrossRef] [PubMed]
- Watach, A.J.; Xanthopoulos, M.S.; Afolabi-Brown, O.; Saconi, B.; Fox, K.A.; Qiu, M.; Sawyer, A.M. Positive Airway Pressure Adherence in Pediatric Obstructive Sleep Apnea: A Systematic Scoping Review. Sleep Med. Rev. 2020, 51, 101273. [Google Scholar] [CrossRef]
- Mihai, R.; Vandeleur, M.; Pecoraro, S.; Davey, M.J.; Nixon, G.M. Autotitrating CPAP as a Tool for CPAP Initiation for Children. J. Clin. Sleep Med. 2017, 13, 713–719. [Google Scholar] [CrossRef] [Green Version]
- Alebraheem, Z.; Toulany, A.; Baker, A.; Christian, J.; Narang, I. Facilitators and Barriers to Positive Airway Pressure Adherence for Adolescents. A Qualitative Study. Ann. Am. Thorac. Soc. 2018, 15, 83–88. [Google Scholar] [CrossRef]
- Parmar, A.; Messiha, S.; Baker, A.; Zweerink, A.; Toulany, A.; Narang, I. Caregiver Support and Positive Airway Pressure Therapy Adherence among Adolescents with Obstructive Sleep Apnea. Paediatr. Child Health 2020, 25, 491–497. [Google Scholar] [CrossRef]
- Hawkins, S.M.M.; Jensen, E.L.; Simon, S.L.; Friedman, N.R. Correlates of Pediatric CPAP Adherence. J. Clin. Sleep Med. 2016, 12, 879–884. [Google Scholar] [CrossRef] [Green Version]
- Xanthopoulos, M.S.; Kim, J.Y.; Blechner, M.; Chang, M.-Y.; Menello, M.K.; Brown, C.; Matthews, E.; Weaver, T.E.; Shults, J.; Marcus, C.L. Self-Efficacy and Short-Term Adherence to Continuous Positive Airway Pressure Treatment in Children. Sleep 2017, 40, 1–7. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Prashad, P.S.; Marcus, C.L.; Maggs, J.; Stettler, N.; Cornaglia, M.A.; Costa, P.; Puzino, K.; Xanthopoulos, M.; Bradford, R.; Barg, F.K. Investigating Reasons for CPAP Adherence in Adolescents: A Qualitative Approach. J. Clin. Sleep Med. 2013, 9, 1303–1313. [Google Scholar] [CrossRef] [Green Version]
- Puri, P.; Ross, K.R.; Mehra, R.; Spilsbury, J.C.; Li, H.; Levers-Landis, C.E.; Rosen, C.L. Pediatric Positive Airway Pressure Adherence in Obstructive Sleep Apnea Enhanced by Family Member Positive Airway Pressure Usage. J. Clin. Sleep Med. 2016, 12, 959–963. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Riley, E.B.; Fieldston, E.S.; Xanthopoulos, M.S.; Beck, S.E.; Menello, M.K.; Matthews, E.; Marcus, C.L. Financial Analysis of an Intensive Pediatric Continuous Positive Airway Pressure Program. Sleep 2017, 40, 1–7. [Google Scholar] [CrossRef] [Green Version]
- Sawyer, A.M.; Gooneratne, N.S.; Marcus, C.L.; Ofer, D.; Richards, K.C.; Weaver, T.E. A Systematic Review of CPAP Adherence across Age Groups: Clinical and Empiric Insights for Developing CPAP Adherence Interventions. Sleep Med. Rev. 2011, 15, 343–356. [Google Scholar] [CrossRef] [Green Version]
- Ghadiri, M.; Grunstein, R.R. Clinical Side Effects of Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnoea. Respirology 2020, 25, 593–602. [Google Scholar] [CrossRef] [PubMed]
- Egesi, A.; Davis, M.D.P. Irritant Contact Dermatitis due to the Use of a Continuous Positive Airway Pressure Nasal Mask: 2 Case Reports and Review of the Literature. Cutis 2012, 90, 125–128. [Google Scholar]
- Tran, K.A.; Doghramji, K. Does Transition From Cpap To Bipap Improve Symptoms Of Aerophagia? Sleep 2018, 41, A203. [Google Scholar] [CrossRef] [Green Version]
- Khaytin, I.; Tapia, I.E.; Xanthopoulos, M.S.; Cielo, C.; Kim, J.Y.; Smith, J.; Matthews, E.C.; Beck, S.E. Auto-Titrating CPAP for the Treatment of Obstructive Sleep Apnea in Children. J. Clin. Sleep Med. 2020, 16, 871–878. [Google Scholar] [CrossRef]
- Shamim-Uzzaman, Q.A.; Bae, C.J.; Ehsan, Z.; Setty, A.R.; Devine, M.; Dhankikar, S.; Donskoy, I.; Fields, B.; Hearn, H.; Hwang, D.; et al. The Use of Telemedicine for the Diagnosis and Treatment of Sleep Disorders: An American Academy of Sleep Medicine Update. J. Clin. Sleep Med. 2021, 17, 1103–1107. [Google Scholar] [CrossRef] [PubMed]
- Johnson, K.G.; Sullivan, S.S.; Nti, A.; Rastegar, V.; Gurubhagavatula, I. The Impact of the COVID-19 Pandemic on Sleep Medicine Practices. J. Clin. Sleep Med. 2021, 17, 79–87. [Google Scholar] [CrossRef]
- King, Z.; Josee-Leclerc, M.; Wales, P.; Masters, I.B.; Kapur, N. Can CPAP Therapy in Pediatric OSA Ever Be Stopped? J. Clin. Sleep Med. 2019, 15, 1609–1612. [Google Scholar] [CrossRef] [PubMed]
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Hady, K.K.; Okorie, C.U.A. Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea. Children 2021, 8, 979. https://doi.org/10.3390/children8110979
Hady KK, Okorie CUA. Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea. Children. 2021; 8(11):979. https://doi.org/10.3390/children8110979
Chicago/Turabian StyleHady, Kelly K., and Caroline U. A. Okorie. 2021. "Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea" Children 8, no. 11: 979. https://doi.org/10.3390/children8110979