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Treatment of sleep disordered breathing with non-invasive positive pressure ventilation (NIV) – our experience


Authors: Šutvajová Dominika;  Igaz Matúš;  Kvaššayová Júlia;  Remeň Lukáš;  Babničová Michaela;  Dvoran Pavol
Authors‘ workplace: Klinika detí a dorastu, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave
Published in: Čes-slov Pediat 2022; 77 (6): 345-352.
Category: Original Papers
doi: https://doi.org/10.55095/CSPediatrie2022/061

Overview

Introduction: The most common group of sleep disorders in the pediatric population is sleep disordered breathing. Obstructive sleep apnea (OSA) in the pediatric population can be considered a relatively common disease with serious clinical consequences. One of the treatment options for severe sleep disordered breathing is treatment with non-invasive positive airway pressure (NIV).

Objective: The aim of this work is to evaluate the effectiveness of NIV in children with sleep disordered breathing in Slovakia.

Methodology: The study was realised in the children’s sleep laboratory at the Klinika detí a dorastu JLF UK a UNM. Patients were screened for sleep disordered breathing, then patients underwent diagnostic all-night PSG with flow capnography based on which they determined the degree and type of sleep disordered breathing. After undergoing diagnostic overnight PSG, patients were initiated for NIV treatment. Patients on NIV treatment after titration were further regularly monitored by a specialist physician in the sleep laboratory.

Results: From 2016 to 2020, we indicated 17 pediatric patients with severe respiratory disorders at the NIV in the KDaD UNM children’s sleep laboratory. 9 (52.94%) patients were set to CPAP mode and 8 (47.06%) patients to BiPAP mode. The most numerous group of patients set for NIV treatment were obese patients (12–70.59%). In obese patients, after titration on a NIV device, we observed a significant improvement in respiratory PSG parameters.

Conclusion: The issue of secondary consequences of obstructive sleep apnea syndrome in children and adults is a highly topical issue in the context of the management of this disease. Proper diagnosis and treatment of sleepdisordered breathing in children is very important for improving the quality of life of these children. NIV treatment is one of the treatment options for OSA with a demonstrably good effect.

Keywords:

obesity – non-invasive ventilation – CPAP – BIPAP – child – sleep disordered breathing – obstructive sleep apnoe


Sources

1. Kaditis AG, Alonso Alvarez ML, Boudewyns A, et al. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J 2016; 47(1): 69–94.

2. Marcus SL, Brooks LJ, Draper KA, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012; 130(3): 576–584.

3. Tauman R, Gozal D. Obstructive sleep apnea syndrome in children. Expert Rev Respir Med 2011; 5(3): 425–440.

4. Villa MP, Sujanska A, Vitelli O, et al. Use of the sleep clinical record in the follow-up of children with obstructive sleep apnea (OSA) after treatment. Sleep Breath 2016; 20(1): 321–329.

5. Suroviaková S, Šujanská A, Ďurdík P, Bánovčin P. Centrálne spánkové apnoe u detí: Central sleep apnea in children. Lekársky obzor: odborný časopis Slovenskej zdravotníckej univerzity v Bratislave. Bratislava: HERBA 2016; 65(11): 433–437.

6. Guilleminault C, Huang YS , Glamann C, et al. Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey. Otolaryngol Head Neck Surg 2007; 136(2): 169–175.

7. Nevšímalová S, Šonka K. Poruchy spánku a bdění. Praha: Galén 2007.

8. Sujanska A, Durdik P, Rabasco J, et al. Surgical and non-surgical therapy of obstructive sleep apnea syndrome in children. Hradec Kralove: ActaMedica 2014; 57(4): 135–141.

9. Berry RB, Brooks R, Gamaldo C, et al. AASM scoring manual updates for 2017 (Version 2.4). J Clin Sleep Med 2017; 13(5): 665–666.

10. Mehta S, Hill NS. Non-invasive ventilation. Am J Resp Crit Care Med 2001; 163(2): 540–577.

11. Mucska I, Hájková M. Metodické odporúčanie hlavného odborníka MZ SR pre odbor pneumológia a ftizeológia: indikácie použitia CPAP v dlhodobej domácej liečbe. Respiro: časopis pre kontinuálne vzdelávanie v pneumológii a ftizeológii. Bardejov: TB-Tlačiareň Bardejov 2015; 13(1): 41–45.

12. Mucska I, et al. Metodické odporúčanie hlavného odborníka MZSR pre odbor pneumológia a ftizeológia a hlavného odborníka MZSR pre odbor pediatrická pneumológia a ftizeológia. Indikácie neinvazívnej pretlakovej ventilácie – NIPV. 2019.

13. Selim B, Ramar K. Sleep-related breathing disorders: When CPAP is not enough. Neurotherapeutics 2021; 18: 81–90.

14. Marcus SL, Brooks LJ, Draper KA, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012; 130(3): 576–584.

15. Andersen IG, Holm JCH, Homoe P. Obstructive sleep apnea in obese children and adolescents, treatment methods and outcome of treatment. A systematic review. Int J Pediatr Otorhinolaryngol 2016; 87: 190–197.

16. Durdik P, Sujanska A, Suroviakova S, et al. Sleep architecture in children with common phenotype of obstructive sleep apnea. J Clin Sleep Med 2018; 14(1): 9–14.

17. Kansra AR, Lakkunarajah S, Jay MS. Childhood and adolescent obesity: A review. Front Pediatr 2021; 8: 581461.

18. Čiljaková M, Vojtková J, Šujanská A, et al. Kvalita spánku detí a adolescentov s diabetes mellitus 1. typu. Čes-slov Pediat 2017; 72 (1): 25–32.

19. Castro-Codesal ML, Dehaan K, Bedi PK, et al. Long-term benefits in sleep, breathing and growth and changes in adherence and complications in children using non-invasive ventilation. Canad J Resp Crit Care Sleep Med 2020; 4(2): 1–9.

20. Wang JJ, Imamura T, Lee J, et al. Continuous positive airway pressure for obstructive sleep apnea in children. Can Fam Physician 2021; 67(1): 21–23.

21. Amaddeo A, Khirani S, Griffon L, et al. Non-invasive ventilation and CPAP failure in children and indications for invasive ventilation. Front Pediatr 2020; 8: 544921.

22. Cassidy S, Schwartz S, Miller J, et al. Prader-Willi syndrome. Genet Med 2012; 14: 10–26.

23. O ’Donnell AR, Bjorson CL, Bohn SG, et al. Compliance rates in children using non-invasive continuous positive airway pressure. Sleep 2006; 29 (5): 651–658.

24. Wearn J, Akpa B, Mokhlesi B. Adherence to positive airway pressure therapy in obesity hypoventilation syndrome. Sleep Med Clin 2021; 16(1): 43–59.

25. Andrade RGS, Viana FM, Nascimento JA, et al. Nasal vs oronasal CPAP for OSA treatment. Chest 2018; 153(3): 665–674.

26. Morley SL. Non-invasive ventilation in paediatric critical care. Paed Resp Rev 2016; 20: 24–31.

27. Chediak AD. Manual titration of positive airway pressure in patients with obstructive sleep apnea. Sleep Med Clinics 2009; 4(3): 443–453.

28. Pavone M, Verrillo E., Caldarelli V, et al. Non-invasive positive pressure ventilation in children. Early Human Development 2013; 89: 25–31.

29. Kennedy B, Lasserson TJ, Wozniak DR, Smith I. Pressure modification or humidification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database Syst Rev 2019; 12(12): CD003531.

30. Hu Y, Su Y, Hu S, et al. Effects of telemedicine interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials. Sleep Breath 2021; 25 (1): 1–8.

31. Schutte-Rodin S. Telehealth, telemedicine, and obstructive sleep apnea. Sleep Med Clin 2020; 15(3): 359–375.

Labels
Neonatology Paediatrics General practitioner for children and adolescents
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