Body position and obstructive sleep apnea in 8–12-month-old infants

SummaryAimTo determine the association between body position and obstructive events during sleep as determined by polysomnography (PSG) in infants of ages 8–12 months with obstructive sleep apnea (OSA).MethodsConsecutive nocturnal polysomnograms (NPSGs) of 50 children ages 8–12 months old referred to the sleep disorders center between 1 January 2003 and 1 June 2006 for possible sleep-disordered breathing were retrospectively reviewed. Data on total obstructive apnea index (AI), total obstructive apnea–hypopnea index (AHI), AI by body position, AHI by body position, rapid eye movement (REM) and non-REM sleep AHI and REM and non-REM AI were recorded.ResultsThe mean age was 9.5 ± 1.9 S.D. months and 46% of the patients were females. There were no significant differences between the mean non-supine AHI (2.0 ± 5.1) and supine AHI (2.5 ± 5.4), p = 0.63. When comparing specific body positions, there were also no significant differences between the mean supine AHI (2.5 ± 5.4), prone AHI (2.9 ± 7.3), left-lateral decubitus AHI (1.1 ± 6.1), or the right-lateral decubitus AHI (2.5 ± 7.6), p = 0.71. Additionally, there were also no significant differences between the mean non-supine AI (0.7 ± 2.9) and supine AI (1.4 ± 3.0), p = 0.23, and no differences between the supine AI (0.7 ± 2.9), prone AI (1.0 ± 2.9), left-lateral decubitus AI (0.3 ± 2.9) or the right-lateral decubitus AI (1.1 ± 3.0), p = 0.44. Children spent an average of 50% of their total sleep time supine. OSA was significantly worse in REM sleep as compared to non-REM sleep (REM AHI 4.3 ± 7.3 versus non-REM AHI 1.4 ± 3.9, p = 0.015; REM AI 5.1 ± 4.9 versus non-REM AI 1.5 ± 4.9, p < 0.001). Mean time in REM sleep was 26% (range 5–42%).ConclusionsThere was no significant effect of body position on sleep-disordered breathing in 8–12 months old infants, although REM sleep represented a significant risk factor for OSA.