CPAP TREATMENT OF OBSTRUCTIVE SLEEP-APNEA AND NEURODEVELOPMENTAL DEFICITS

Four boys aged 6-16 years with neurodevelopmental deficits were treate d with CPAP for obstructive sleep apnoea. Their diagnoses were: Obesit y with mild mental retardation, (2) attention deficit hyperactivity di sorder, (3) epilepsy associated with left hemiparesis and (4) mild men tal retardation due to fragile X syndrome. Previous therapeutic attemp ts, including adenotonsillectomy, amitriptyline and methylphenidate in our patients prior to CPAP treatment were unsuccessful. A follow-up p eriod of 12-48 months demonstrated a number of clinical benefits such as improvement in sleep quality and daily arousal, and a decrease in t he frequency of seizures and episodes of pneumonia. Polysomnographic s tudies indicated a significant improvement in sleep parameters such as apnoea frequency, awakenings, sleep efficiency and arterial oxygen sa turation. Side effects were mild and readily alleviated. CPAP is a fea sible therapeutic intervention in intractable obstructive sleep apnoea of childhood, even when associated with neurodevelopmental deficits.