0787 Clinical Observations and Characteristics of a Pediatric Cohort with OSA Treated with PAP for over 10 Years

Abstract Introduction Despite intensive treatment and follow-up, adherence to positive airway pressure in children is poor, with many losing the device or simply being lost to follow-up. The purpose of this study was to describe the characteristics of and management interventions in a cohort of 28 patients with obstructive sleep apnea treated with positive airway pressure followed in a pediatric sleep center for 10 years or longer. Methods A retrospective chart review was performed on patients diagnosed with obstructive sleep apnea and treated with positive airway pressure that were followed in clinic between May 2007 and December 2023. Those that followed up for less than 10 years were excluded from the analysis. Demographic and clinical variables were reviewed. A descriptive statistical analysis was performed. Results In this cohort (85.7% male), the median age (interquartile range) at PAP initiation was 4 years (2-7). Comorbidities included 42.9% obese, 39.3% allergic rhinitis, 35.7% asthma, 28.6% intellectual disability, 17.9% ADHD, 17.9% Prader-Willi syndrome, 10.7% autism, and 10.7% Down syndrome. 92.9% received tonsillectomy, 85.7% adenoidectomy, 50% uvulapalatopharyngoplasty, and 10.7% turbinate trim. . Polysomonogram (PSG) results [median (IQR)] included apnea-hypopnea index 15.89 per hour (10.15-29.25), arousal index 15.7per hour (11.85-25.85), 77.8% had oxygenation defects, and 22.2% ventilation defects.67.9% (19) participated in an intensive adherence program, with 42.1% (8) graduating the program The most common interventions/recommendations were mask/tubing replacement (22.2%), PSG ordered (11.8%), pressure change (10.5%), and changing mask type (10.3%). Of those changing masks, 45.3% changed from nasal to full-face, 15.1% from full-face to hybrid, and 13.2% from hybrid to full-face. Median PAP adherence across all patients and visits was 94.15 (81.88-99) and usage for four hours or more was 77.9 (54.10-90.93). Conclusion This study provides a detailed overview of demographical and clinical characteristics of and the management interventions for OSA in a pediatric cohort followed for over a decade. Further statistical analyses including multivariate analyses are in progress. Support (if any) none