What is New with Management of Pediatric Central Sleep Apnea?

Central Sleep Apnea (CSA) in children is a far less studied and understood abnormality compared to Obstructive Sleep Apnea (OSA). It is seen more often in younger patient population mostly with co-morbidity. There are structural abnormalities in the brain, spinal cord, airway and chest wall or functional disorders in respiratory control, hemoglobin concentration, swallowing or cardiovascular system, resulting in CSA. Clinical observation of central apneic events prompts further evaluation ideally done by performing Polysomnography testing (sleep study) to confirm the presence and estimate the severity. Various medical and surgical treatment options result in improvement or resolution of the central apneic events. Majority of the patients show a gradual resolution of the disorder with age. However a minority of patients continue to manifest the disorder and require longer term treatment mostly by using respiratory support in the form of invasive or non-invasive ventilation. More research is needed to explore treatment options for children.

Keywords: Central sleep apnea, Pediatrics, Polysomnographic study, Sleep disordered breathing.