Obstructive sleep apnoea in children –a neglected entity

Authors

  • Biniyam K. Department Of Otorhinolaryngology, Justice K S Hegde Charitable Hospital, K S Hegde Medical Academy, Mangalore, Karnataka, India
  • Amulya M. Thotambailu Department Of Otorhinolaryngology, Justice K S Hegde Charitable Hospital, K S Hegde Medical Academy, Mangalore, Karnataka, India http://orcid.org/0000-0002-8547-9019
  • Shrinath Kamath Department Of Otorhinolaryngology, Justice K S Hegde Charitable Hospital, K S Hegde Medical Academy, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20171181

Keywords:

Paediatric obstructive sleep apnoea, Sleep disordered breathing

Abstract

Background: Obstructive sleep apnoea syndrome (OSAS) is a spectrum which includes primary snoring, upper airway resistance syndrome, obstructive hypoventilation and obstructive sleep apnoea. Sleep disordered breathing  (SDB) is characterized by snoring, witnessed apnoea, frequent arousal, mouth breathing, restless sleep, irritability, recurrent upper respiratory tract infections etc.

Methods: This was a prospective observational study which included 20 children who presented to the otorhinolaryngology, pulmonary medicine, paediatric, oral and maxillofacial department were included in the study with clinical symptoms of obstructive sleep apnoea.  

Results: 20 children, 13 (65%) males and 7 (35%) females were included. Snoring was the most common complaint.15 (75%) were obese, 5 had adenotonsillar hypertrophy(25%) as the risk factor for OSA. 15 out of the 20 children were graded under mallampati class 1(75%), 4  class 2(20%), 1under class 3(5%). There was no significant association in severity of OSA between 2 genders (p=0.82). Positive correlation (r=0.52) was found between AHI and BMI and is found to be statistically significant (p=0.02), which suggests that degree of obesity does predict the severity of OSA.

Conclusions: Obesity is the most significant risk factor among them followed by adenotonsillar hypertrophy. Hence children who snore should undergo polysomnography and necessary corrective measures should be prescribed.

Author Biographies

Biniyam K., Department Of Otorhinolaryngology, Justice K S Hegde Charitable Hospital, K S Hegde Medical Academy, Mangalore, Karnataka, India

ASSISTANT PROFESSOR

DEPT OF OTORHINOLARYNGOLOGY

Amulya M. Thotambailu, Department Of Otorhinolaryngology, Justice K S Hegde Charitable Hospital, K S Hegde Medical Academy, Mangalore, Karnataka, India

POSTGRADUATE

DEPARTMENT OF OTORHINOLARYNGOLOGY

Shrinath Kamath, Department Of Otorhinolaryngology, Justice K S Hegde Charitable Hospital, K S Hegde Medical Academy, Mangalore, Karnataka, India

ASSOCIATE PROFESSOR

DEPT OF OTORHINOLARYNGOLOGY

References

American Thoracic Society. Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med. 1996;153:866-78.

Medicine AAoS, editor. The international classification of sleep disorders, 2nd ed. Diagnostic and coding manual. Westchester, Illinois: American Academy of Sleep Medicine; 2005.

Gozal D, Burnside MM. Increased upper airway collapsibility in children with obstructive sleep apnoea during wakefulness. Am J Respir Crit Care Med. 2004;169:163-7.

Marcus CL, McColley SA, Carroll JL, Loughlin GM, Smith PL, Schwartz AR. Upper airway collapsibility in children with obstructive sleep apnoea syndrome. J Appl Physiol. 1994;77:918-24.

Arens R, McDonough JM, Costarino AT, Mahboubi S, Tayag-kier CE, Maislin G, et al. Magnetic resonance imaging of the upper airway structure of children with obstructive sleep apnoea syndrome. Am J Respir CritCare Med. 2001;164: 698-703.

Sullivan S, Li K, Guilleminault C. Nasal obstruction inchildren with sleep-disordered breathing. Ann Acad Med Singapore. 2008;37:645-8.

Peltomaki T. The effect of mode of breathing on craniofacial growth--revisited. Eur J Orthod. 2007; 9:426-9.

Johal A, Patel SI, Battagel JM. The relationship between craniofacial anatomy and obstructive sleep apnoea: a case controlled study. J Sleep Res. 2007;16:319-26.

Loffredo L, Zicari AM, Occasi F, Perri L, Carnevale R, Angelico F, et al. Endothelial dysfunction and oxidative stress in children with sleep disordered breathing: role of NADPH oxidase. Atherosclerosis. 2015;240(1):222-7.

Sinha D, Guilleminault C. Sleep disordered breathing in children. Indian J Med Res. 2010;131:311-20.

Chan J, Edman JC, Koltai PJ. Obstructive sleep apnea in children. Am Fam Physician. 2004;69:1147-54.

Ersu R, Arman AR, Save D, Karadag B, Karakoc F, Berkem M, Dagli E. Prevalence of snoring and symptoms of sleep-disordered breathing in primary school children in Istanbul. Chest. 2004;126:19-24.

Gozal D, Pope DW Jr. Snoring during early childhood and academic performance at ages 13 to 14 years. Pediatrics. 2001;107:1394-9.

Miller VA, Palermo TM, Powers SW, Scher MS, Hershey AD. Migraine headaches and sleep disturbances in children. Headache. 2003;43:362-8.

Mallory GB, Fiser DH, Jackson R. Sleep-associated breathing disorders in morbidly obese children and adolescents. J Pediatr. 1989;115(6):892-7.

Narang I, Mathew JL. Childhood obesity and obstructive sleep apnea. J Nutr Metabol. 2012.

Katz S, Murto K, Barrowman N, Clarke J, Hoey L, Momoli F, Laberge R, Vaccani JP. Neck circumference percentile: a screening tool for pediatric obstructive sleep apnea. Pediatr Pulmonol. 2015;50(2):196-201.

Nanaware SK, Gothi D, Joshi JM. Sleep apnea. The Indian J Pediatr. 2006;73(7):597-601

Tripuraneni M, Paruthi S, Armbrecht ES, Mitchell RB. Obstructive sleep apnea in children. The Laryngoscope. 2013 May 1;123(5):1289-93.

Downloads

Published

2017-03-25

Issue

Section

Original Research Articles