title: Obstructive sleep apnea in infancy: a 7-year experience at a pediatric sleep center.
abstract: OBJECTIVE
  To investigate the common indications for polysomnogram (PSG) associated co-morbid conditions, evaluation strategies, treatment options, and outcomes in a series of infants diagnosed with obstructive sleep apnea (OSA) by a PSG.
  
  
  METHODS
  Retrospective chart review of infants who underwent PSG over a 7-year period was done. Infants with PSG diagnosed OSA were included in this study.
  
  
  RESULTS
  A total of 97 infants (59 males, mean age 4.6 months, standard deviation 3.3 months) were diagnosed with OSA (AHI ≥ 1/hr) based on PSG. The most common indication for PSG in infants were excessive snoring (53%) followed by nocturnal desaturations (24%). Associated co-morbid conditions included gastro-esophageal reflux (30%), laryngomalacia (24%), and craniofacial abnormalities (16%). Genetic abnormalities were found in 53%, of which trisomy 21 was the most common. Surgical treatments were employed in 36% and oxygen therapy in 15%. Thirty-eight patients were followed up with a repeat sleep study after a median interval of 8 months (range 1-24 months), of whom 26/38 had resolution of symptoms. Twenty-seven patients (28%) were followed clinically after a mean interval of 5 months of intervention (range, 1-34.5 months), in whom the symptoms resolved in 23/27 patients. Seven patients were deceased at review. Causes of death included status epilepticus, respiratory failure, hepatic failure, kidney failure, or unknown causes.
  
  
  CONCLUSIONS
  The etiologies of OSA in infants are different when compared to older children. PSG is feasible and a valuable tool in the diagnosis of OSA in infants and may help determine timely and appropriate evaluation and interventions. Clinical improvement in symptoms and resolution of PSG parameters were noted following medical and/or surgical interventions. Prospective studies need to be done to ascertain the long-term outcome of infants diagnosed with OSA to assess the benefits of early intervention on their neurocognitive development.
authors.affiliation: Department of Neurology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sriram
authors.initials: S
authors.lastname: Ramgopal
authors.forename: Sanjeev V
authors.initials: SV
authors.lastname: Kothare
authors.forename: Mandeep
authors.initials: M
authors.lastname: Rana
authors.forename: Kanwaljit
authors.initials: K
authors.lastname: Singh
authors.forename: Umakanth
authors.initials: U
authors.lastname: Khatwa
mesh_terms: D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017286:Polysomnography / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy
keywords: infant sleep apnea; infants; obstructive sleep apnea; polysomnography; sleep apnea