Children with Congenital Central Hypoventilation Syndrome Do Not Wake up to Ventilator Alarms

• Published in: Sleep & breathing Vol. 26; no. 3; pp. 1277 - 1280
• Main Authors: Mathur, Shreya, Laifman, Eric, Keens, Thomas G., Kun, Sheila, Ward, Sally L. Davidson, Perez, Iris A.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2022; Springer Nature B.V
• Subjects: Carbon dioxide; Dentistry; Diaphragm; Genotypes; Hypoventilation; Internal Medicine; Medicine; Medicine & Public Health; Neurology; Nursing; Ostomy; Otorhinolaryngology; Pediatrics; Phox2b protein; Pneumology/Respiratory System; Pulse oximetry; Sleep; Sleep Breathing Physiology and Disorders • Short Communication; Tracheostomy; Ventilators; Pulse oximeter; Ventilator; Monitoring alarms; Sleep; Diaphragm pacing; CCHS
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-021-02452-7

Purpose Congenital Central Hypoventilation Syndrome (CCHS) requires lifelong ventilatory support during sleep. Subjects with CCHS are vulnerable to sleep disturbances associated with treatments, monitoring alarms, and care they receive. We hypothesized that sleep would be disrupted in patients  with CCHS due to ventilatory support and other treatments at night. Methods An anonymous survey of patients with CCHS, age up to 17 years was conducted through REDCAP. Subjects were recruited in person, by flyer, email, and social media. Data collected included demographics, PHOX2B genotype, ventilatory support, treatments, nursing, and sleep parameters. Results We received 23 responses (35% female, 8.1 years ± 5.6). PHOX2B genotypes were 20/24 PARM (2), 20/25 PARM (4), 20/26 PARM (2), 20/27 PARM (9), ≥ 20/28 PARM (2), and NPARM (2). Two subjects did not indicate the PHOX2B genotype. 13/23 were ventilated by PPV via tracheostomy, 7 by NIPPV, 2 by diaphragm pacing, and 1 did not indicate. Additional treatments received at night included suctioning (9), aerosol (1), G-tube feeding (2), and none (11). Only 9 received nursing at night. 13 used pulse oximetry for monitoring, and 9 used both pulse oximetry and end tidal CO 2 monitor. 17/23 rarely woke up due to ventilator or monitor alarms. 11/23 usually or sometimes woke up at least once a night; only 2/11 woke up due to alarms. 5/17 who rarely woke up to the alarms had night nursing. Conclusion Most subjects with CCHS did not awaken to ventilator or monitoring alarms and a majority of these patients did not have nighttime nursing. (Mathur et al. in Sleep 43(Supplement_1):A333, 2020 )