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Body position and obstructive sleep apnea in children
Lucila B Fernandes do Prado1, Xianbin Li, Richard Thompson
1Department of Neurology and Internal Medicine, (Universidade Federal de São Paulo-Escola Paulista de Medicina), São Paulo, Brazil.
Insights
Children with obstructive sleep apnea breathe best in the supine position, unlike adults. This study analyzed sleep position and obstructive apnea in children, finding supine sleep improved breathing.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive sleep apnea (OSA) is a common condition in children.
- In adults, supine sleep position exacerbates OSA, but this relationship is not well-established in pediatric populations.
Purpose of the Study:
- To investigate the association between sleep position and obstructive apnea severity in children.
- To compare positional effects on sleep apnea in obese versus non-obese children.
Main Methods:
- Retrospective analysis of polysomnography data from 80 children (aged 1-10 years) with suspected OSA.
- Sleep position (supine, prone, side) was monitored using sensors and video recordings.
- Obstructive apnea-hypopnea index (OAHI) and apnea duration were analyzed based on sleep position.
Main Results:
- Children exhibited a lower OAHI in the supine position compared to the prone position.
- Apnea duration was shorter when children slept supine versus on their side.
- Positional effects on sleep apnea were similar in both obese and non-obese children.
Conclusions:
- Contrary to adults, children with obstructive sleep apnea demonstrate improved breathing in the supine sleep position.
- Sleep position is a significant factor influencing OSA severity in children.
Study Objectives:
In adults, sleep apnea is worse when the patient is in the supine position. However, the relationship between sleep position and obstructive apnea in children is unknown. The objective of this study was to evaluate the relationship between obstructive apnea and body position during sleep in children.
Design:
Retrospective analysis of the relationship between body position and obstructive apnea in obese and non-obese children.
Setting:
Tertiary care pediatric sleep center.
Patients:
Otherwise healthy children, aged 1-10 years, undergoing polysomnography for suspected obstructive sleep apnea syndrome. Obese and non-obese children were evaluated separately.
Interventions:
Retrospective review of the relationship between sleep position and obstructive apnea during polysomnography.
Measurements And Results:
Eighty polysomnograms from 56 non-obese and 24 obese children were analyzed. Body position was determined by a sensor during polysomnography, and confirmed by review of videotapes. Children had a lower obstructive apnea hypopnea index when supine vs. prone, and shorter apneas when supine then when on their side. There was no difference in apnea duration between the supine and prone positions. Obese and non-obese children showed similar positional changes.
Conclusions:
Children with obstructive sleep apnea, in contrast to adults, breathe best when in the supine position.