Am. J. Respir. Crit. Care Med., Vol 153, No. 1, Jan 1996, 51-55.
Effects of overnight supplemental oxygen in obstructive sleep apnea in children
G Aljadeff, D Gozal, SL Bailey-Wahl, B Burrell, TG Keens and SL Ward
Division of Neonatology and Pediatric Pulmonology, Childrens Hospital Los Angeles, University of Southern California School of Medicine 90027, USA.
Supplemental oxygen during sleep may be useful as a temporary palliative
treatment in children with obstructive sleep apnea syndrome (OSAS)
associated with significant hypoxemia. However, supplemental O2 may also
blunt hypoxic ventilatory drive and worsen ventilation. To assess the
safety of the use of supplemental O2 in children with OSAS, we studied 16
children ages 2-8 (mean: 4.28 +/- 2.88 yr) with OSAS secondary to
adenotonsillar hypertrophy. Patients underwent two overnight polysomnograms
within 1 mo, one on room air (RA) and one while receiving supplemental O2
via nasal cannula titrated by 1/4 lpm increments to achieve SpO2 > 95%
during the first hour of sleep. Oxygenation measurements were significantly
improved during supplemental O2 nights (average SpO2 increased from 89.5
+/- 4.8% on RA to 97.7 +/- 1.8% on supplemental O2 [p < 0.00001]) while
alveolar ventilation remained unchanged (PETCO2 > 50 mm Hg: 3.6 +/- 8.9%
total sleep time on RA and 3.3 +/- 6.3% total sleep time on supplemental O2
[p = NS]). Supplemental O2 significantly reduced hypopnea density,
obstructive apnea index, and paradoxical breathing. The density and average
duration of central apneas remained unchanged. In addition, supplemental O2
increased the percentage of REM sleep time and decreased the number of
microarousals. We conclude that supplemental O2 might be a safe and
beneficial temporary treatment in children with OSAS.
