Obstructive sleep apnea syndrome during the first year of life in Robin sequence RS: a prospective and longitudinal polysomnography PSG study

<bold>Title:</bold> Obstructive sleep apnea syndrome OSAS during the 1st year of life in Robin sequence: a prospective and longitudinal polysomnography PSG study <bold>Objectives:</bold> Data from PSG and its impact on OSAS management are rare in RS infants. This study aimed at comparing OSAS and its therapeutic option before and after 6 months in PSG. <bold>Methods:</bold> Prospective study conducted in 2 tertiary hospital (2018-2021): 2 PSG (PSG1 0-3 months and PSG2 6-10 months of life) performed in RS infants in different conditions (supine position SP, lateral P LP, prone P PP, with/without ventilatory support VS) analysed by 1 reviewer. OSAS management (SP,LP,PP,continuous positive airway pressure CPAP,high flow nasal canula HFNC,nasopharyngeal tube NPT, tracheostomy; adherence, tolerance, secondary effects) was notified. <bold>Results:</bold> Among the 45 RS(median[IQR] age at PSG1 2[1-3], PSG2 8[6-10] months), in SP or LP without VS, sleep efficacy was lower in PSG1 than in PSG2(76%[60-82] versus 87%[78-92],p<0.03). In the PP without VS, sleep efficacy was equivalent between PSG1 and PSG2. In SP or LP without VS, obstructive apnea hypopnea index OAHI was higher at PSG1 than at PSG2(17/h[10-36] versus 4/h[3-6],p<0.01). In PP without VS, OAHI was higher at PSG1 than at PSG2(10/h[6-17] versus 2/h[2-5],p=0.03). Among 45 infants, 28(62%) used PP for 6[1-8]months, 7(15%)HFNC and 23(52%)CPAP for 1[0-3]months, 6(13%)NPT for 4[3-6]months. The therapeutic option was modified for 18(40%) infants after the PSG1 and 14(41%) after the PSG2. <bold>Conclusion:</bold> Sleep and OAHI improve widely during first months of life approaching normal at 8 months. An early PSG could be useful to adapt accuratly OSAS management.