Effects of nasal continuous positive airway pressure on apnoea index and sleep in infants

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Abstract
We examined the effectiveness of nasal continuous positive airway pressure (CPAP) for treatment of sleep apnoea in infants.We studied five infants who all had significant central and mixed apnoea and severe sleep fragmentation. Polysomnographic recordings were performed on 2 consecutive nights in these infants. One night was used as a control study and during the second night nasal CPAP was applied throughout the night.Nasal CPAP significantly reduced apnoea in each infant, with the apnoea index (apnoeas/h) decreasing from 65.6 +/- 14.6 during the control study to 10.5 +/- 14.6 during CPAP in non-rapid eye movement (non-REM) sleep, and from 106 +/- 13.9 during the control study to 26.6 +/- 13.9 during CPAP in REM sleep. Nasal CPAP also improved the sleep fragmentation markedly; REM sleep increased from 14.2 +/- 1.2% of sleep during the control study to 27.1 +/- 1.2% of sleep during CPAP.We conclude that nasal CPAP is an effective treatment for infantile apnoea. Sleep apnoea in these infants is associated with profound sleep fragmentation, which is reversed by nasal CPAP.