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Objective sleepiness measures in pediatric obstructive sleep apnea
1Kosair Children's Hospital Sleep Medicine and Apnea Center, Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, Louisville, Kentucky 40202, USA. david.gozal@louisville.edu
Insights
Excessive daytime sleepiness (EDS) is infrequent in children with obstructive sleep apnea (OSA), despite shortened sleep latencies. EDS in pediatric OSA patients is more common in those with severe apnea or obesity.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Disorders
Background:
- Excessive daytime sleepiness (EDS) is common in adults with obstructive sleep apnea (OSA).
- The prevalence of EDS in pediatric patients with OSA is not well-established.
Purpose of the Study:
- To investigate the incidence of daytime sleepiness in children diagnosed with OSA.
- To determine the relationship between sleepiness, apnea severity, and obesity in pediatric OSA.
Main Methods:
- A cohort of 54 children with OSA, 14 with primary snoring (PS), and 24 controls (C) underwent polysomnography.
- A multiple sleep latency test (MSLT) was administered the following day to assess daytime sleepiness.
Main Results:
- Children with OSA had a mean apnea index of 15.1, significantly higher than PS (1.1) and controls (0.1).
- Mean sleep latencies were 20.0 minutes for OSA patients, comparable to PS (23.7) and controls (23.7).
- Only 7 OSA patients exhibited sleep latencies under 10 minutes, with shorter latencies linked to higher obesity and apnea severity.
Conclusions:
- Shortened sleep latencies are present in pediatric OSA, but EDS is not a frequent occurrence.
- Daytime sleepiness in pediatric OSA tends to be more prevalent in patients with severe apnea and/or obesity.
Objectives:
Excessive daytime sleepiness (EDS) occurs frequently in adult patients with obstructive sleep apnea (OSA). However, the incidence of EDS in children with OSA is unknown.
Methods:
To determine overall daytime sleepiness in pediatric OSA, 54 children with OSA, 14 children with primary snoring (PS), and 24 controls (C) underwent an overnight diagnostic polysomnogram followed the next day by a multiple sleep latency test.
Results:
The mean apnea index was 15.1 +/- 9.5 standard deviation in OSA, 1.1 +/- 0.5 in PS, and 0.1 +/- 0.3 in C. Mean sleep latencies were 23.7 +/- 3.0 minutes in C, 23.7 +/- 3.1 minute in PS, and 20.0 +/- 7.1 minute in OSA patients. However, only 7 children with OSA had mean sleep latencies <10 minutes. In addition, shorter sleep latencies were more likely to occur in more obese OSA patients and those with more severe apnea index, and oxyhemoglobin desaturation.
Conclusions:
Shortened sleep latencies occur in children with OSA, but EDS is infrequent and tends to develop among more severe and/or obese patients.