Background

In children with Obstructive Sleep Apnoea (OSA) and no comorbidities, nocturnal CO₂ monitoring does not influence the therapeutic management (Trucco ERJ 2018). However, we do not know the proportion of children with no comorbidities nor OSA, but with alveolar hypoventilation who could benefit from CO₂ results in their management.

Objective

The main aim of this study was to describe the distribution of alveolar hypoventilation in children without comorbidities according to the presence (and severity) of OSA.

Methods

This is a retrospective, descriptive, single-center study (Trousseau hospital, Paris) conducted using our database of sleep recordings in children aged 0 to 18 years, referred for OSA screening between 2019 and 2022. We excluded children with comorbidities, except for mild to moderate controlled asthma, and children using non-invasive ventilator support. Hypoventilation was defined as CO₂>50mmHg>25% of recorded nighttime. Proportions were compared using the Fisher's exact test.

Results

We retrieved a single recording in 130 patients with a median [IQR] age of 5.4 [3.7; 8.9] years, (48 (37%) females, 50 (38%) with asthma). Results are shown in the Table.

Compared to children without hypoventilation, all children with hypoventilation had OSA of severe grade for nearly all of them (P<0.0001).

In conclusion, we did not detect children with alveolar hypoventilation but no OSA in our study population in favour of not systematically record CO₂ in these children when there is no clinical signs suggesting nocturnal hypercarbia.