CPAP for paediatric patients in Aotearoa New Zealand: audit of a developing service at Capital and Coast DHB 2005-2020.

Aims: To document the establishment of a Paediatric Continuous Positive Airway Pressure (CPAP) service within the Wellington Region, and review outcomes over the last 15 years.

Methods: A retrospective audit of the Paediatric Sleep Service records including clinic letters and polysomnography (PSG) studies for all paediatric patients commenced on CPAP treatment, or for whom CPAP treatment was offered, from November 2005 to December 2020. Data were collected on demographics, medical diagnoses, indications for respiratory support, ENT involvement and surgery. Factors related to CPAP use were also recorded.

Results: Seventy-four children were offered CPAP in the time frame, 52 (70%) male. The age range at onset of CPAP treatment was <1 year of age to 23 years with 12 cases ≥16 years of age. There were 3 (4%) cases presenting before 2006, 11 (15%) cases from 2006-2010, 16 (22%) cases from 2011-2015 and 44 (59%) cases between 2016-2020. Ethnicities included were, 32 (43%) NZ European, 18 (24%) Māori, 19 (26%) Pacific and 5 (7%) Indian/Asian. The most common primary diagnoses were Obesity 21 (28%), Down Syndrome 10 (14%) and Craniofacial abnormalities 8 (11%). One family declined a CPAP trial and there were eight failed CPAP trials. For the remaining 65 patients, compliance with treatment was good/usually good for 25, variable for 19, and poor for 21. Māori patients were less likely to have good/usually good compliance than NZ European and Pacific patients (25% versus 44% and 47% respectively).

Conclusion: Referrals for CPAP treatment in the paediatric age range are increasing and obesity is the commonest co-morbidity. Services need to be culturally appropriate to ensure the best outcomes.