A new study published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine, shows that treating childhood obstructive sleep apnea syndrome (OSAS) with positive airway pressure (PAP) therapy improves several significant neurobehavioral outcomes.
Leading researcher Carole L. Marcus, professor of pediatrics at the Children's Hospital of Philadelphia said:
"In our study of 52 children and adolescents with OSAS, we observed significant improvements in neurobehavioral function after three months of PAP therapy. These improvements were seen despite suboptimal adherence with treatment and were observed in a heterogeneous group of children, many with underlying medical conditions and/or developmental delays."
The researchers performed neurobehavioral assessments in 52 children aged between 8 and 16 years (average 12 years) with OSAS, of which 10 had substantial developmental delays. The researchers assessed the children's sleepiness, behavioral problems, attention and quality of life at baseline and following three months of PAP treatment. They noted large differences in patient adherence to PAP treatment, ranging from 25 to 315 minutes per night, with an average of 170 minutes.
PAP treatment was linked to substantial improvements in attention deficits, behavior, sleepiness and caregiver- and child-reported quality of life. The researchers observed that improvements in sleepiness scores were strongly associated with adherence, with similar improvements in behavioral scores in the subset of children with developmental delays. Improvement in other outcomes was not noted. In children below aged between 3 to 7 years (average age 4.5 years) substantial improvements were achieved in sleepiness and OSAS-specific quality of life.
Dr. Marcus commented:
"OSAS in children is known to be associated with behavioral disturbances and learning deficits, but the effects of PAP therapy on these deficits have not been studied. Our study is the first to demonstrate that PAP therapy results in significant improvements in a range of neurobehavioral domains in these patients, including those with developmental delays."
The researchers acknowledge the study's limitations, which included using only reports made by subjects and caregivers, the lack of a placebo group, and the lack of blinding.
Dr. Marcus concluded:
"The improvements we observed in daytime sleepiness, attention, internalizing behaviors and quality of life occurred despite a mean use of PAP of only three hours a night. This suggests that PAP use should be encouraged in children with OSAS, even in those with suboptimal adherence, as it can lead to improvements in function that can in turn affect family, social and school function."
Written by Petra Rattue