0884 Trajectory of Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA) in Infants with Bronchopulmonary Dysplasia (BPD)

Abstract Introduction Previous studies have shown that sleep disordered breathing (SDB) is common in infants with BPD. The extent to which BPD modifies the natural trajectory of SDB remains unclear. The aim of this study is to investigate longitudinal trends of OSA and CSA in infants with BPD compared to other infants from NICU Methods This retrospective study in NICU patients from 2005-2025 who had ≥ 2 PSGs the first 24 months of life. Longitudinal changes in AHI, obstructive AHI (OAHI), central apnea index (CAI), REM% were analyzed at 0-3, 3-6, 6-12 and > 12 months. Mixed effects linear regression models were used for longitudinal changes in SDB indices and their interaction with BPD. Resolution of SDB (OAHI < 2/hr CAI< 5/hr) was evaluated using Kaplan-Meier methods. Results 930 infants with corresponding 2690 PSGs met the criteria for analysis. The cohort was divided into 2 groups (1) BPD (n=101, 10.9%), 62.4% male with a mean gestation age of 28.8 weeks (2) non-BPD group (n=829, 89.1%), 56.2% male with a mean gestational age of 37.3 weeks. AHI, OAHI and CAI declined significantly with increasing age in the entire cohort (p < 0.0001) and in the BPD group (P< 0.0001) with no effect of BPD on changes in SDB indices (P=NS). REM% declined with age in both BPD and non-BPD (P< 0.0001), but there was a trend toward slow reduction of REM% with age in the BPD group (p = 0.058). Kaplan-Meier demonstrated no significant difference in the timing of resolution of OSA between BPD and non-BPD infants (21.2[BPD] vs 20.6 months[non-BPD], log rank p=0.09). BPD infants showed slower resolution in CSA compared to non-BPD infants (6.4[BPD] vs 2.1 months[non-BPD], log-rank p < 0.0001). Conclusion In this cohort of NICU infants, there were significant reductions in both OSA and CSA with increasing ages in both BPD and non-BPD groups. Resolution of OSA occurred at a similar time in BPD and non-BPD infants, while slower resolution of CSA was noted in the BPD group. We speculate that delayed maturation of central respiratory control may contribute to prolonged resolution of CSA in BPD population. Support (if any) Cincinnati Children’s Research Foundation