Supplemental oxygen during sleep in children with sleep-disordered breathing

Supplemental O₂ is sometimes used to treat children with the obstructive sleep apnea syndrome (OSAS). However, its effects have not been studied. We therefore evaluated the use of supplemental O₂ during sleep in children with OSAS. Oxygen and room air were delivered via nasal cannula at 1 L/min for 4 h each in a randomized, double-blind fashion. Twenty-three children were studied (mean age, 5 ± 3 [SD] yr). Patients had a higher mean SaO₂ and higher SaO₂ nadir when breathing O₂. There was no difference in the number (10.9 ± 20.6/h on O₂ versus 13.5 ± 19.3 on room air) or duration of obstructive apneas. Although there was no overall change in end-tidal PCO₂ when patients breathed O₂, two children showed a significant increase. We conclude that breathing supplemental O₂ during sleep in children with OSAS results in improved oxygenation and in most cases does not exacerbate sleep- disordered breathing. However, end-tidal PCO₂ should be monitored in children with OSAS receiving O₂ therapy. We speculate that supplemental O₂ does not depress the ventilatory drive during sleep in most children with OSAS.