Nasal mask continuous positive airway pressure in the treatment of chronic nocturnal cough in a young child.
The objective of this case report was to define the effects of nasal mask continuous positive airway pressure (CPAP) on the respiratory and sleep characteristics of a 3 year-old boy with a 2 year history of snoring and 1 year history of chronic nocturnal cough. The method employed was all-night polysomnography before and during treatment with CPAP after the identification of partial upper airway obstruction in association with cough. The results indicated that the child had evidence of mild upper airways obstruction on initial all-night sleep study. Nasal mask CPAP was instituted. On a subsequent sleep study 4 weeks later, this was documented to prevent the upper airway obstruction at a pressure of 5.2 cm of water. In addition, nasal mask CPAP markedly reduced the nocturnal coughing, the total number of coughs decreasing from 92 to one. The rate of cough per h of study (cough disturbance index) decreased from 9.8-0.1. Sleep efficiency (total sleep time as a percentage of study duration) improved on CPAP from 87 to 99%. This study suggests that chronic nocturnal cough can result from upper airway obstruction in sleep in children and is an important initial observation.
Teng
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AY
Sleep Medicine Unit, Sydney Children's Hospital, Randwick, Australia.
Sullivan
C E
CE
D002675:Child, Preschool; D002908:Chronic Disease; D003371:Cough / Q000503:physiopathology / Q000628:therapy*; D004569:Electroencephalography; D006801:Humans; D008297:Male; D008397:Masks; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods*; D012891:Sleep Apnea Syndromes / Q000503:physiopathology / Q000628:therapy*; D012894:Sleep Stages