AI Article Synopsis
- Sleep disordered breathing (SDB) is less common in children with chronic heart failure (CHF) compared to adults, but the effects of treatment like CPAP on their health are still being explored.
- In a study involving 30 children with CHF, most showed normal sleep efficiency and low rates of severe SDB, with only minor cases of obstructive symptoms.
- Using CPAP effectively reduced the work of breathing and respiratory rate in kids receiving treatment, without harming their cardiac function.
Article Abstract
Background: Sleep disordered breathing (SDB) is common in adults with chronic heart failure (CHF), but its prevalence in children remains unclear. Continuous positive airway pressure (CPAP) is the treatment of SDB but deleterious hemodynamic effects have been reported.
Methods: We prospectively analyzed SDB in children with CHF and the effect of CPAP on work of breathing (WOB) and cardiac index (CI). Children aged 6 months to 18 years old with CHF due to: 1) dilated cardiomyopathy (DM) with an ejection fraction < 45%, 2) functional single ventricle (SV) or 3) aortic or mitral valve disease awaiting surgery (VD) were eligible for the study. A polysomnography (PSG), measurement of WOB and CI during spontaneous breathing (SB) and CPAP (6, 8 and 10 cmHO) were performed.
Results: Thirty patients with mean age of 6.4 ± 5 years were included (16 DM 16, 10 SV, 4 LV). Twenty (73%) patients had a normal sleep efficiency. Median apnoeas hypopnea index (IAH) was within normal range at 1.6 events/h (0, 14) events/hour. Only one patient had central sleep apnoeas, none had Cheyne-Stokes respiration, and 3 patients had an obstructive AHI between 5 and 10 events/hour. Optimal CPAP level decreased WOB (p = 0.05) and respiratory rate (p = 0.01).
Conclusions: Severe SDB was uncommon in children with CHF. However, CPAP may be beneficial by decreasing WOB and respiratory rate without deleterious effects on CI.
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| http://dx.doi.org/10.1016/j.sleep.2021.04.003 | DOI Listing |
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