Obstructive sleep apnea in infants

Eliot S. Katz, Ron B. Mitchell, Carolyn M. D'Ambrosio

Research output: Contribution to journalReview article

101 Scopus citations

Abstract

Obstructive sleep apnea in infants has a distinctive pathophysiology, natural history, and treatment compared with that of older children and adults. Infants have both anatomical and physiological predispositions toward airway obstruction andgas exchange abnormalities; including a superiorly placed larynx, increased chestwall compliance, ventilation-perfusion mismatching, and ventilatory control instability. Congenital abnormalities of the airway, such as laryngomalacia, hemangiomas, pyriform aperture stenosis, choanal atresia, and laryngeal webs, may also have adverse effects on airway patency. Additional exacerbating factors predisposing infants toward airway collapse include neck flexion, airway secretions, gastroesophageal reflux, and sleep deprivation. Obstructive sleep apnea in infants has been associatedwith failure to thrive, behavioral deficits, and sudden infant death. The proper interpretation of infant polysomnography requires an understanding of normative data related to gestation and postconceptual age for apnea, arousal, and oxygenation. Direct visualization of the upper airway is an important diagnostic modality in infants with obstructive apnea. Treatment options for infant obstructive sleep apnea are predicated on the underlying etiology, including supraglottoplasty for severe laryngomalacia, mandibular distraction formicrognathia, tonsillectomy and/or adenoidectomy, choanal atresia repair, and/or treatment of gastroesophageal reflux.

Original languageEnglish (US)
Pages (from-to)805-816
Number of pages12
JournalAmerican journal of respiratory and critical care medicine
Volume185
Issue number8
DOIs
StatePublished - Apr 15 2012

Keywords

  • Adenotonsillar hypertrophy
  • Craniofacial
  • Laryngomalacia
  • Micrognathia
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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