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Evaluation of Obstructive Sleep Apnea in Prone Versus Nonprone Body Positioning With Polysomnography in Infants With Robin Sequence
Objective: Management of obstructive sleep apnea in infants with Robin sequence (RS) includes prone positioning during sleep, which conflicts with safe infant sleep data. We examined changes in polysomnography (PSG) parameters for prone versus nonprone body positions in these infants. Design: Pre–po...
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| Published in: | The Cleft palate-craniofacial journal 2020-02, Vol.57 (2), p.141-147 |
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| Main Authors: | , , , , , |
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| cites | cdi_FETCH-LOGICAL-c365t-c3f0af3f171b2d3e98875afa592961bf1c3834d1e35b365d8a5c8e3849b89c2b3 |
| container_end_page | 147 |
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| container_start_page | 141 |
| container_title | The Cleft palate-craniofacial journal |
| container_volume | 57 |
| creator | Hong, Hanna Wee, Choo Phei Haynes, Karla Urata, Mark Hammoudeh, Jeffrey Ward, Sally L. Davidson |
| description | Objective:
Management of obstructive sleep apnea in infants with Robin sequence (RS) includes prone positioning during sleep, which conflicts with safe infant sleep data. We examined changes in polysomnography (PSG) parameters for prone versus nonprone body positions in these infants.
Design:
Pre–post interventional, nonblinded study.
Participants:
Infants with RS referred for PSG were recruited from craniofacial clinic and inpatient units at Children’s Hospital Los Angeles, a tertiary pediatric center. Fourteen infants were recruited, and 12 studies were completed on both body positions; 11 studies were used in the analysis.
Interventions:
The PSG was divided into nonprone and prone sleep, moving from their usual sleep position to the other position midway in the study.
Main Outcome Measures:
Data was collected in each position for obstructive apnea–hypopnea index (oAHI), central apnea index (CAI), sleep efficiency (SE), and arousal index (AI). Signed rank test was used to evaluate the change in body position.
Results:
All infants were term except 1, age 7 to 218 days (mean: 55 days; standard deviation: 58 days), and 8 (57%) of 14 were female. From nonprone to prone sleep position, the median oAHI (16.0-14.0), CAI (2.9-1.0), and AI (28.0-19.9) decreased (P = .065); SE increased (67.4-85.2; P = .227).
Conclusions:
Prone positioning may benefit some infants with RS. However, even those with significant improvement in obstructive sleep apnea did not completely resolve their obstruction. The decision to use prone positioning as a therapy should be objectively evaluated in individual infants. |
| doi_str_mv | 10.1177/1055665619867228 |
| format | article |
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Management of obstructive sleep apnea in infants with Robin sequence (RS) includes prone positioning during sleep, which conflicts with safe infant sleep data. We examined changes in polysomnography (PSG) parameters for prone versus nonprone body positions in these infants.
Design:
Pre–post interventional, nonblinded study.
Participants:
Infants with RS referred for PSG were recruited from craniofacial clinic and inpatient units at Children’s Hospital Los Angeles, a tertiary pediatric center. Fourteen infants were recruited, and 12 studies were completed on both body positions; 11 studies were used in the analysis.
Interventions:
The PSG was divided into nonprone and prone sleep, moving from their usual sleep position to the other position midway in the study.
Main Outcome Measures:
Data was collected in each position for obstructive apnea–hypopnea index (oAHI), central apnea index (CAI), sleep efficiency (SE), and arousal index (AI). Signed rank test was used to evaluate the change in body position.
Results:
All infants were term except 1, age 7 to 218 days (mean: 55 days; standard deviation: 58 days), and 8 (57%) of 14 were female. From nonprone to prone sleep position, the median oAHI (16.0-14.0), CAI (2.9-1.0), and AI (28.0-19.9) decreased (P = .065); SE increased (67.4-85.2; P = .227).
Conclusions:
Prone positioning may benefit some infants with RS. However, even those with significant improvement in obstructive sleep apnea did not completely resolve their obstruction. The decision to use prone positioning as a therapy should be objectively evaluated in individual infants.</description><identifier>ISSN: 1055-6656</identifier><identifier>EISSN: 1545-1569</identifier><identifier>DOI: 10.1177/1055665619867228</identifier><identifier>PMID: 31382772</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Babies ; Dentistry ; Posture ; Sleep apnea ; Studies</subject><ispartof>The Cleft palate-craniofacial journal, 2020-02, Vol.57 (2), p.141-147</ispartof><rights>2019, American Cleft Palate-Craniofacial Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-c3f0af3f171b2d3e98875afa592961bf1c3834d1e35b365d8a5c8e3849b89c2b3</citedby><cites>FETCH-LOGICAL-c365t-c3f0af3f171b2d3e98875afa592961bf1c3834d1e35b365d8a5c8e3849b89c2b3</cites><orcidid>0000-0001-9293-7500</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,783,787,27936,27937,79756</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31382772$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hong, Hanna</creatorcontrib><creatorcontrib>Wee, Choo Phei</creatorcontrib><creatorcontrib>Haynes, Karla</creatorcontrib><creatorcontrib>Urata, Mark</creatorcontrib><creatorcontrib>Hammoudeh, Jeffrey</creatorcontrib><creatorcontrib>Ward, Sally L. Davidson</creatorcontrib><title>Evaluation of Obstructive Sleep Apnea in Prone Versus Nonprone Body Positioning With Polysomnography in Infants With Robin Sequence</title><title>The Cleft palate-craniofacial journal</title><addtitle>Cleft Palate Craniofac J</addtitle><description>Objective:
Management of obstructive sleep apnea in infants with Robin sequence (RS) includes prone positioning during sleep, which conflicts with safe infant sleep data. We examined changes in polysomnography (PSG) parameters for prone versus nonprone body positions in these infants.
Design:
Pre–post interventional, nonblinded study.
Participants:
Infants with RS referred for PSG were recruited from craniofacial clinic and inpatient units at Children’s Hospital Los Angeles, a tertiary pediatric center. Fourteen infants were recruited, and 12 studies were completed on both body positions; 11 studies were used in the analysis.
Interventions:
The PSG was divided into nonprone and prone sleep, moving from their usual sleep position to the other position midway in the study.
Main Outcome Measures:
Data was collected in each position for obstructive apnea–hypopnea index (oAHI), central apnea index (CAI), sleep efficiency (SE), and arousal index (AI). Signed rank test was used to evaluate the change in body position.
Results:
All infants were term except 1, age 7 to 218 days (mean: 55 days; standard deviation: 58 days), and 8 (57%) of 14 were female. From nonprone to prone sleep position, the median oAHI (16.0-14.0), CAI (2.9-1.0), and AI (28.0-19.9) decreased (P = .065); SE increased (67.4-85.2; P = .227).
Conclusions:
Prone positioning may benefit some infants with RS. However, even those with significant improvement in obstructive sleep apnea did not completely resolve their obstruction. The decision to use prone positioning as a therapy should be objectively evaluated in individual infants.</description><subject>Babies</subject><subject>Dentistry</subject><subject>Posture</subject><subject>Sleep apnea</subject><subject>Studies</subject><issn>1055-6656</issn><issn>1545-1569</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kctr3DAQxkVo6Kab3nMqgl56ceKRVrJ0TEPaLoRsyPNoZHu0cfBKjmQH9tx_vNpuHhDIRY_5ft83A0PIAeSHAEVxBLkQUgoJWsmCMbVD9kDMRAZC6k_pneRso0_Ilxgf8pwJYOozmXDgihUF2yN_T59MN5qh9Y56SxdVHMJYD-0T0qsOsafHvUNDW0cvgndIbzHEMdJz7_r__5--WdMLH9tNQuuW9K4d7lOhW0e_cn4ZTH-_3tjnzho3xK1-6atUusLHEV2N-2TXmi7i1-d7Sm5-nV6f_MnOFr_nJ8dnWc2lGNJpc2O5hQIq1nDUShXCWCM00xIqCzVXfNYAclElQ6OMqBVyNdOV0jWr-JT82Oam0VPnOJSrNtbYdcahH2PJmFR6BkwWCf3-Dn3wY3BpupJxLrUWoHWi8i1VBx9jQFv2oV2ZsC4hLzcLKt8vKFm-PQeP1QqbV8PLRhKQbYFolvjW9cPAf-eYmP4</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Hong, Hanna</creator><creator>Wee, Choo Phei</creator><creator>Haynes, Karla</creator><creator>Urata, Mark</creator><creator>Hammoudeh, Jeffrey</creator><creator>Ward, Sally L. Davidson</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9293-7500</orcidid></search><sort><creationdate>202002</creationdate><title>Evaluation of Obstructive Sleep Apnea in Prone Versus Nonprone Body Positioning With Polysomnography in Infants With Robin Sequence</title><author>Hong, Hanna ; Wee, Choo Phei ; Haynes, Karla ; Urata, Mark ; Hammoudeh, Jeffrey ; Ward, Sally L. Davidson</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-c3f0af3f171b2d3e98875afa592961bf1c3834d1e35b365d8a5c8e3849b89c2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Babies</topic><topic>Dentistry</topic><topic>Posture</topic><topic>Sleep apnea</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hong, Hanna</creatorcontrib><creatorcontrib>Wee, Choo Phei</creatorcontrib><creatorcontrib>Haynes, Karla</creatorcontrib><creatorcontrib>Urata, Mark</creatorcontrib><creatorcontrib>Hammoudeh, Jeffrey</creatorcontrib><creatorcontrib>Ward, Sally L. Davidson</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The Cleft palate-craniofacial journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hong, Hanna</au><au>Wee, Choo Phei</au><au>Haynes, Karla</au><au>Urata, Mark</au><au>Hammoudeh, Jeffrey</au><au>Ward, Sally L. Davidson</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of Obstructive Sleep Apnea in Prone Versus Nonprone Body Positioning With Polysomnography in Infants With Robin Sequence</atitle><jtitle>The Cleft palate-craniofacial journal</jtitle><addtitle>Cleft Palate Craniofac J</addtitle><date>2020-02</date><risdate>2020</risdate><volume>57</volume><issue>2</issue><spage>141</spage><epage>147</epage><pages>141-147</pages><issn>1055-6656</issn><eissn>1545-1569</eissn><abstract>Objective:
Management of obstructive sleep apnea in infants with Robin sequence (RS) includes prone positioning during sleep, which conflicts with safe infant sleep data. We examined changes in polysomnography (PSG) parameters for prone versus nonprone body positions in these infants.
Design:
Pre–post interventional, nonblinded study.
Participants:
Infants with RS referred for PSG were recruited from craniofacial clinic and inpatient units at Children’s Hospital Los Angeles, a tertiary pediatric center. Fourteen infants were recruited, and 12 studies were completed on both body positions; 11 studies were used in the analysis.
Interventions:
The PSG was divided into nonprone and prone sleep, moving from their usual sleep position to the other position midway in the study.
Main Outcome Measures:
Data was collected in each position for obstructive apnea–hypopnea index (oAHI), central apnea index (CAI), sleep efficiency (SE), and arousal index (AI). Signed rank test was used to evaluate the change in body position.
Results:
All infants were term except 1, age 7 to 218 days (mean: 55 days; standard deviation: 58 days), and 8 (57%) of 14 were female. From nonprone to prone sleep position, the median oAHI (16.0-14.0), CAI (2.9-1.0), and AI (28.0-19.9) decreased (P = .065); SE increased (67.4-85.2; P = .227).
Conclusions:
Prone positioning may benefit some infants with RS. However, even those with significant improvement in obstructive sleep apnea did not completely resolve their obstruction. The decision to use prone positioning as a therapy should be objectively evaluated in individual infants.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>31382772</pmid><doi>10.1177/1055665619867228</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9293-7500</orcidid></addata></record> |
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| ispartof | The Cleft palate-craniofacial journal, 2020-02, Vol.57 (2), p.141-147 |
| issn | 1055-6656 1545-1569 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2268941267 |
| source | Sage Journals Online |
| subjects | Babies Dentistry Posture Sleep apnea Studies |
| title | Evaluation of Obstructive Sleep Apnea in Prone Versus Nonprone Body Positioning With Polysomnography in Infants With Robin Sequence |
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