Heart Defects, Sleep Apnea a Deadly Mix for Infants

THURSDAY, Sept. 20, 2018 — Infants who are born with heart defects are four times more likely to die in the hospital if they also have sleep apnea, new research indicates.

Scientists at the University of Arizona College of Medicine in Tucson found this potentially deadly combination is also linked to longer and more costly hospital stays.

“We were surprised that, together, these two conditions had such a strong association with death,” said study co-author Dr. Sairam Parthasarathy, a sleep specialist at the university.

For the study, the researchers analyzed data from a national database of pediatric discharge information collected from more than 4,100 community hospitals in the United States.

They identified 4,968 infants with congenital heart disease who were also diagnosed with sleep apnea between 1997 and 2012. The infants were all diagnosed with the sleep disorder by their first birthday.

Of these children, 193 had central sleep apnea, which occurs when the body temporarily pauses or reduces breathing efforts during sleep. Meanwhile, 679 of the infants had obstructive sleep apnea, which occurs when the throat muscles relax and temporarily block the airway. The discharge documents on the remaining 4,096 infants did not specify the type of sleep apnea the children had.

“By studying a limited supply of data, we only got a snapshot of these hospital cases. We were not able to see everything, like what medications the infants were on or what diagnosis they had,” said study leader Dr. Daniel Combs, a sleep specialist at the university.

Still, the analysis revealed that infants with central sleep apnea and a heart abnormality had the worst outcomes. These babies were four times more likely to die in the hospital. Their hospitalizations were also twice as long and twice as costly as the other infants.

“Screening is important to prevent this. We have to lower our threshold to screen for sleep apnea; that could improve these negative outcomes,” Combs said in a university news release. “If we learn that infants do have sleep apnea, we can refer them for treatment.”

Central sleep apnea is treated with supplemental oxygen or a therapeutic device that assists with breathing. Removing the tonsils often cures obstructive sleep apnea in children, the researchers added.

They noted that parents of children with congenital heart disease should have their child screened for sleep apnea.

The study findings were published Sept. 17 in the Journal of Clinical Sleep Medicine.

More information

The U.S. National Library of Medicine provides more information on congenital heart disease.

Posted: September 2018

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