0788 Effect of Sleep State and Position on Obstructive Respiratory Events in 12 - 24-month-old Toddlers

Abstract Introduction As per our knowledge, very limited number of studies have investigated the effect of sleep states and body positions on respiratory events distribution in toddlers aged 12-24 months. We aimed to investigate this relationship in this specific age group. Methods This was a single center, retrospective study that included normal toddlers between the ages of 12 and 24 months diagnosed with OSA with overnight polysomnography. Toddlers with obstructive apnea hypopnea index (OAHI) of 2 or greater were included. Patients with Down syndrome, neuromuscular disease were excluded. REM, NREM and different body positions AHI were collected, in addition to REM and NREM mean end-tidal carbon dioxide level (EtCO2) and mean oxygen saturation (SaO2). Results A total of 95 toddlers (68 males, 27 females) between 12 and 24 months old met the criteria. 48.4% of patients were Caucasian, 37.9% were African American and 4.2% were Hispanic. Median times (%) spent in REM and NREM were 21 and 79.1, respectively. Median time (minutes) in different body positions were supine 147, right side 53.4, left side 58.5, and prone 42.35. Median REM AHI was 8.45, higher than median NREM AHI of 1.1 (p< 0.001, IQR: 3.475-24.875 and IQR: 0.3-4.5, respectively). Median REM SaO2 was 98% (IQR: 97-99) and median NREM SaO2 was 98 %( IQR: 97-99), with no statistical difference. REM EtCO2 median was 41 (IQR: 40-44) and median NREM was 42 (IQR: 40-44), with no statistical difference. Median AHI while supine was 2.15 (IQR: 0.4-9.1), on right side was 0.8 (IQR: 0-7.25), on left side was 1.1(IQR: 0-8.8), and while prone was 0 (IQR: 0-5.2). The median supine AHI compared to off-supine AHI showed no significant difference (p=0.6252). Conclusion Toddlers suffering from OSA have worsening AHI during REM sleep, however their SaO2 and EtCO2 does not significantly change compared to NREM sleep. Additionally, sleep position does not affect AHI distribution this population. Support (if any)