title: Detection of sleep associated dysfunctional pharyngeal obstruction in infants.
abstract: Six infants were referred with symptoms and clinical signs suggesting airway obstruction during sleep. In each case, overnight recordings of arterial oxygen saturation, respiratory movements and end tidal expired carbon dioxide (ETCO2) showed the presence of abnormal episodes of hypoxaemia related to partial or complete airway obstruction and associated with a specific pattern of the inspiratory movement waveforms. These events and patterns were not found on recordings from 20 age-matched healthy infants and young children. ETCO2 levels were also abnormally elevated in all six patients when asleep. Fiber-optic upper airway endoscopy excluded structural abnormalities, including significant tonsillar or adenoidal enlargement, but showed an intermittent dysfunctional inspiratory obstruction in the pharynx. Continuous positive airways pressure and tracheostomy were effective in treating this obstruction.
authors.affiliation: Department of Paediatrics, Cardiothoracic Institute, Brompton Hospital, London, United Kingdom.
authors.forename: D P
authors.initials: DP
authors.lastname: Southall
authors.forename: C B
authors.initials: CB
authors.lastname: Croft
authors.forename: V A
authors.initials: VA
authors.lastname: Stebbens
authors.forename: H
authors.initials: H
authors.lastname: Ibrahim
authors.forename: A
authors.initials: A
authors.lastname: Gurney
authors.forename: R
authors.initials: R
authors.lastname: Buchdahl
authors.forename: J O
authors.initials: JO
authors.lastname: Warner
mesh_terms: D000402:Airway Obstruction / Q000503:physiopathology*; D001143:Arousal / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D005183:Failure to Thrive / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000097:blood; D010614:Pharynx / Q000503:physiopathology; D012891:Sleep Apnea Syndromes / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology*
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen