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35 Management of central apnoeas – analysis of a paediatric cohort referred to a tertiary care sleep service
  1. Sairah Akbar1,
  2. Ridma Jayarathna1,
  3. Siobhan Kenny1,
  4. Hannah Williams1,
  5. Alex Thomas1,
  6. Sakina Dastagir1,
  7. Ruth O’Reilly1,
  8. Rishi Pabary1,
  9. Hui-Leng Tan1 and
  10. Federica Trucco2
  1. 1Department of Paediatric Sleep and Ventilation/Respiratory Medicine, Royal Brompton Hospital, London, UK
  2. 2Department of Paediatric Neuroscience, Guy’s and St Thomas’ NHS trust and Department Paediatric Respiratory medicine, Royal Brompton Hospital, London, UK


Introduction Central sleep apnoea (CSA) is common in childhood and is usually clinically associated with developmental delay, syndromes, brain and/or brainstem involvement. The threshold for significant CSA remains controversial. Only one study so far has described CSA in a large paediatric cohort.1

The aim of this study was to review the prevalence, clinical correlation and management of CSA in a cohort of paediatric patients referred to a tertiary UK sleep service.

Methods Retrospective study of children <18 years referred to the paediatric sleep service for a sleep study between April 2018-July 2020. We included patients with a cAHI of ≥1. Patients with previous sleep studies, diagnosis of CSA and on ventilatory support or oxygen therapy were excluded.

Results 162 patients were included with a median age of 2.7 years (range 9 days to 9.7 years). 129 patients had isolated cAHI of 1-5 without association with obstructive sleep apnoea (OSA), defined as oAHI>5. 14 had isolated cAHI ≥5 and 19 had CSA with OSA.

Patients with isolated cAHI 1-5 had no specific clinical features except adenotonsillar hypertrophy. Isolated severe CSA was identified in ex-preterm or complex neurodisability (table 1). Only severe CSA patients had further investigations to exclude a central/genetic cause (table 2).

45 patients with a cAHI of 1-5 had a follow-up study. of these, 41/45 had a comparable CSA severity with cAHI <5. 4 patients had cAHI 1-5 but newly identified OSA on follow-up.

Abstract 35 Table 1

Background and severity of cAHI

Abstract 35 Table 2

Investigation and management cAHI - 1-5 vs ≥5

Discussion Our analysis shows that children with an isolated cAHI of 1-5 had reproducible results on follow-up study. There was an association between CSA≥5 and OSA which has not been reported in the literature suggesting the central component may resolve after treating OSA.


  1. Ghirardo S, Amaddeo A, Griffon L, et al. Central apnea and periodic breathing in children with underlying conditions. J Sleep Res 2021:e13388.

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