Objective The aim of the study was to describe the characteristics of otherwise healthy children with obstructive sleep apnea (OSA; OSA-I) and children with OSA and obesity (OSA-II) treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in 2019 in France. Design National cross-sectional survey. Patients Children with OSA-I and OSA-II. Main outcome measures Initiation criteria, age, adherence, equipment and settings Results Patients with OSA-I and OSA-II represented 6% (n=84, 71% males) and 10% (n=144, 72% males) of the national cohort, respectively. The apnea-hypopnea index (63% vs 76%), alone or combined with nocturnal gas exchange (25% vs 21%, for OSA-II and OSA-I patients respectively) were used as initiation criteria of CPAP/NIV. OSA-II patients were older at CPAP/NIV initiation (mean age 11.0±4.0 vs 6.8±4.5 years, p<0.001) and were treated for a longer time (2.3±2.6 vs 1.3±1.5 years, p=0.008) than OSA-I patients. NIV was used in 6% of OSA-I patients and 13% of OSA-II patients (p=0.142). Nasal mask was the most used interface in both groups. Mean CPAP level was higher in OSA-II patients as compared to OSA-I patients (8.7±2.0 vs 7.7±2.4 cmH 2O, p=0.02). Objective compliance was comparable (mean use 6.8±2.6 vs 5.9±3.0 hours/night in OSA-I and OSA-II, respectively, p=0.054). Conclusion Six and 10% of children treated with long term CPAP/NIV in France in 2019 had OSA-I and OSA-II, respectively. Both groups were preferentially treated with CPAP and were comparable except for age, with OSA-II patients being older.

Background: The ability to perceive bronchial obstruction is variable in asthma. This is one of the main causes of inaccurate asthma control assessment, on which therapeutic strategies are based. Objective: Primary: To evaluate the ability of a clinical and spirometric telemonitoring device to characterize symptom perception profile in asthmatic children. Secondary: To evaluate its impact on asthma management (control, treatment, respiratory function variability) and the acceptability of this telemonitoring system. Method: 26 asthmatic children aged 6-18 years equipped with a portable spirometer and a smartphone application were monitored remotely for 3 months. Clinical and spirometric data were automatically transmitted to a secure internet platform. A medical team contacted the patient to optimize management. Three physicians blindly and independently classified the patients according to their perception profile. The impact of telemonitoring on the quantitative data was assessed at the beginning (T0) and end (T3 months) of telemonitoring, using matched statistical tests. Results: Patients could initially be classified according to their perception profile, with a concordance between the 3 observers of 64% (kappa coefficient: 0.55, 95%CI [0.39; 0.71]). After further discussion, a consensus was reached and resulted in 97% concordance (kappa coefficient: 0.97, 95%CI [0.91; 1.00]). There was a trend towards improvement in the ACT score, and a significant > 40% decrease in FEV1 and PEF variability, with good acceptance of the device. Conclusion: Clinical and spirometric telehome monitoring is applicable and can help define the perception profile of bronchial obstruction in asthmatic children. The device was generally well accepted.