Obstructive Sleep Apnea: Risk Factors Among Infants

Infants with obstructive sleep apnea (OSA) may experience changes in cognitive development, temperament, and behavior. Symptoms in infants may be non-specific, so identifying infants with the greatest risk for OSA is significant. A study that was published online as part of the ATS 2020 International Conference examined demographics and comorbidities associated with OSA in infants.

Babies aged <2 years presenting to a tertiary care sleep center with sleep-related problems between March 2016 and June 2017 were retrospectively reviewed; data collection included demographics, sleep intake patient questionnaire, and diagnostic billing codes for comorbidities and sleep diagnoses.

Final analysis included 578 infants, of whom just over half (n=324; 56%) were diagnosed with OSA (per the International Classification of Diseases, 10th revision code 327.23). Infants diagnosed with OSA were significantly younger and more likely to be female (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.043-2.145). Infants with OSA also had a higher prevalence of:

  • Bronchopulmonary dysplasia (OR, 1.56; 95% CI, 1.018-2.390)
  • Hypoxia (OR, 3.56; 95% CI, 2.35-5.40)
  • Craniofacial anomalies (OR, 2.35; 95% CI, 1.09-5.05)
  • Neuromuscular weakness (OR, 3.39; 95% CI, 1.47-7.79)
  • Pulmonary hypertension (OR, 2.11; 95% CI, 1.01-4.40)
  • Seizures (OR, 1.56; 95% CI, 1.06-2.30)
  • Reflux (OR, 2.53; 95% CI, 1.69-3.77)
  • Laryngomalacia (OR, 4.51; 95% CI, 2.82-7.27)
  • Feeding dysfunction (OR, 3.08; 95% CI, 2.16-4.38)

Infants with OSA were not significantly more likely than those without to report snoring or difficulty breathing.

“Female gender, hypoxia, laryngomalacia, trisomy 21, and feeding dysfunction are independent risk factors associated with infant OSA. To our knowledge, this is the first study describing an association between feeding dysfunction and infant OSA. Future studies are needed to explore the relationship between these risk factors and infant OSA,” the study authors concluded.