Am. J. Respir. Crit. Care Med., Vol 152, No. 4, 10 1995, 1297-1301.
Supplemental oxygen during sleep in children with sleep-disordered breathing
CL Marcus, JL Carroll, O Bamford, P Pyzik and GM Loughlin
Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Supplemental O2 is sometimes used to treat children with the obstructive
sleep apnea syndrome (OSAS). However, its effects have not been studied. We
therefore evaluated the use of supplemental O2 during sleep in children
with OSAS. Oxygen and room air were delivered via nasal cannula at 1 L/min
for 4 h each in a randomized, double-blind fashion. Twenty-three children
were studied (mean age, 5 +/- 3 [SD] yr). Patients had a higher mean SaO2
and higher SaO2 nadir when breathing O2. There was no difference in the
number (10.9 +/- 20.6/h on O2 versus 13.5 +/- 19.3 on room air) or duration
of obstructive apneas. Although there was no overall change in end-tidal
PCO2 when patients breathed O2, two children showed a significant increase.
We conclude that breathing supplemental O2 during sleep in children with
OSAS results in improved oxygenation and in most cases does not exacerbate
sleep-disordered breathing. However, end-tidal PCO2 should be monitored in
children with OSAS receiving O2 therapy. We speculate that supplemental O2
does not depress the ventilatory drive during sleep in most children with
OSAS.
