HOME NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE IN INFANTS WITH SLEEP-DISORDERED BREATHING

Objective: To review our experience with home nasal continuous positiv e airway pressure (CPAP) in infants with small upper airways and abnor mal breathing during sleep. Study design: Seventy-four infants with sl eep-disordered breathing and narrow upper airways, as identified by no cturnal polygraphic recording and endoscopic evaluation, were treated at home with nasal CPAP, Infants with craniofacial anomalies and triso my 21, and infants who had been referred to us as having had ''apparen t life-threatening events,'' made up the majority of the population. B ecause of the rapid growth of infants, regular follow-up visits were s cheduled to adjust CPAP and mask size. Results: Seventy-two infants we re successfully treated at home with nasal CPAP; there were two failur es, Follow-up lasted from 5 months to 12 years. Compliance was not a p roblem, but home nasal CPAP was prescribed only for infants who lived close to our center and whose families and pediatricians were willing to support compliance. Comments: Home nasal CPAP requires careful, in- laboratory titration and regular follow-up to adjust both pressure and mask size, With the support of families and pediatricians, home nasal CPAP can be an effective treatment for infants with upper airway resp iratory problems during sleep, In many cases, it can provide an interi m solution, enabling physicians to plan surgery at an appropriate time and giving infants time to grow before having to undergo surgical str ess.