Obstructive sleep apnea in infants

  • E.S. K
  • R.B. M
  • C.M. D
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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. Copyright © 2012 by the American Thoracic Society.

Author-supplied keywords

  • *sleep apnea syndrome/di [Diagnosis]
  • *sleep apnea syndrome/et [Etiology]
  • *sleep apnea syndrome/su [Surgery]
  • *sleep apnea syndrome/th [Therapy]
  • Pierre Robin syndrome/su [Surgery]
  • Pierre Robin syndrome/th [Therapy]
  • REM sleep
  • adenoidectomy
  • adenotonsillectomy
  • airway obstruction
  • apnea
  • arousal
  • behavior disorder
  • body posture
  • breathing
  • breathing pattern
  • breathing rate
  • bronchoscopy
  • carbon dioxide
  • chemoreceptor reflex
  • choana atresia/su [Surgery]
  • cleft palate
  • congenital disorder
  • craniofacial development
  • craniofacial synostosis
  • disease association
  • disease predisposition
  • distraction osteogenesis
  • electroencephalogram
  • endotracheal tube
  • face growth
  • facial nerve injury/co [Complication]
  • facial scarring/co [Complication]
  • failure to thrive
  • gastroesophageal reflux
  • hemangioma
  • human
  • intubation
  • laryngomalacia/su [Surgery]
  • laryngoscopy
  • larynx
  • larynx surgery
  • larynx web
  • lip
  • lung gas exchange
  • mandible
  • mandible fracture/su [Surgery]
  • mandibular distraction
  • maxilla
  • micrognathia
  • musculoskeletal function
  • nasopharyngeal airway intubation
  • nasopharyngeal intubation
  • neck flexion
  • nonREM sleep
  • nose
  • nose obstruction
  • nose surgery
  • ontogeny
  • orthopedic surgery
  • oxygenation
  • pathophysiology
  • polysomnography
  • postoperative complication/co [Complication]
  • pregnancy
  • prematurity
  • priority journal
  • pulse oximetry
  • pyriform aperture stenosis
  • respiratory function
  • respiratory tract intubation
  • review
  • scar formation/co [Complication]
  • sleep
  • sleep deprivation
  • sleep time
  • snoring
  • soft tissue
  • stenosis
  • subglottic stenosis
  • sudden infant death syndrome
  • supraglottoplasty
  • thorax wall
  • tongue
  • tonsillectomy
  • tooth bud disruption/co [Complication]
  • tooth injury/co [Complication]
  • tracheostomy
  • tracheotomy
  • tube
  • upper airway resistance syndrome
  • upper respiratory tract

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  • Katz E.S.

  • Mitchell R.B.

  • D'Ambrosio C.M.

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