The treatment of sleep apnea in young children using bilevel positive airway pressure

Česká verzia

Authors: I. Příhodová ¹; K. Šonka ¹; M. Pretl ¹; P. Klement ²; M. Jakoubková ¹; D. Kemlink ¹; P. Jiroutek ¹; S. Nevšímalová ¹
Authors place of work: Neurologická klinika VFN a 1. LF UK, Praha ¹; Klinika dětského a dorostového lékařství VFN a 1. LF UK, Praha ²
Published in the journal: Cesk Slov Neurol N 2007; 70/103(4): 429-434
Category: Case Report

Summary

Sleep apnea is prevailingly caused by an obstruction in the upper respiratory tract (URT); less often it is linked with a central respiratory control disorder. The factors contributing to the development of sleep apnea are adenoid vegetation and tonsillar hypertrophy combined with slight deviations in the structure and functioning of the URT. All diseases causing anatomic or functional changes in the URT (craniofacial malformations, achondroplasias, gastroesophageal reflux, Down syndrome, poliomyelitis, nerve-muscle diseases) also involve the risk of sleep apnea. The treatment of first choice for sleep apnea in child age is adenotonsilectomy. Treatment with constant positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) in children is reserved for states in which adenotonsilectomy is not indicated for or ineffective in the treatment of obstructive sleep apnea (OSA), and for central apnea. We include case studies of 3 child patients aged between 1,5 to 5 years successfully treated by BiPAP. We point out the necessity for early diagnosing and treatment of sleep apnea in risk patients and the good compliance with BiPAP treatment in infant and pre-school age.

Key words:
obstructive sleep apnoea – central sleep apnea – child age – constant positive airway pressure – bilevel positive airway pressure

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