Treatment of obstructive sleep apnea in pediatric patients. Behavioral intervention for compliance with nasal continuous positive airway pressure.

This study evaluated the efficacy of behavioral techniques (i.e., parent training, modeling, and desensitization) to facilitate use of nasal continuous positive airway pressure (CPAP) in four children with obstructive sleep apnea (OSA) secondary to anatomic disorder of the upper airway. All patients tolerated CPAP with training: Polysomnographic data revealed improvement in sleep architecture, apnea, and oxygenation, and patients were discharged on CPAP units. All patients continued to use CPAP throughout the 3-month follow-up period and none required additional treatment for OSA. Three of four patients continued to use CPAP at the 9-month follow-up visit. Treatment resulted in improvements in alertness, attention/concentration, and behavior/temperament. Children generally have been considered poor candidates for nasal CPAP, and historically they have been offered instead more invasive procedures. This study suggests that CPAP is a viable treatment for such children when paired with behavioral interventions that facilitate its use.