EFFECTS OF OVERNIGHT SUPPLEMENTAL OXYGEN IN OBSTRUCTIVE SLEEP-APNEA IN CHILDREN

Supplemental oxygen during sleep may be useful as a temporary palliati ve treatment in children with obstructive sleep apnea syndrome (OSAS) associated with significant hypoxemia. However, supplemental O-2 may a lso blunt hypoxic ventilatory drive and worsen ventilation. To assess the safety of the use of supplemental O-2 in children with OSAS, we st udied 16 children ages 2-8 (mean: 4.28 +/- 2.88 yr) with OSAS secondar y to adenotonsillar hypertrophy. Patients underwent two overnight poly somnograms within 1 mo, one on room air (RA) and one while receiving s upplemental O-2 via nasal cannula titrated by 1/4 Ipm increments to ac hieve SpO(2) > 95% during the first hour of sleep. Oxygenation measure ments were significantly improved during supplemental O-2 nights (aver age SpO(2) increased from 89.5 +/- 4.8% on RA to 97.7 +/- 1.8% on supp lemental O-2 [p < 0.00001]) while alveolar ventilation remained unchan ged (PET(CO2) > 50 mm Hg: 3.6 +/- 8.9% total sleep time on RA and 3.3 +/- 6.3% total sleep time on supplemental O-2 [p = NS]). Supplemental O-2 significantly reduced hypopnea density, obstructive apnea index, a nd paradoxical breathing. The density and average duration of central apneas remained unchanged. in addition, supplemental O-2 increased the percentage of REM sleep time and decreased the number of microarousal s. We conclude that supplemental O-2 might be a safe and beneficial te mporary treatment in children with OSAS.