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Nasal corticosteroids for children with snoring

Emmanouel I Alexopoulos1, Athanasios G Kaditis, Efthimia Kalampouka

  • 1Department of Pediatrics, University of Thessaly School of Medicine, Larissa, Greece.

Pediatric Pulmonology
|June 24, 2004
PubMed

Insights

Four weeks of nasal budesonide effectively treated mild sleep-disordered breathing in children, improving both polysomnography results and symptoms. The positive effects persisted for months after treatment concluded.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Medicine
  • Pharmacology

Background:

  • Previous research indicated nasal corticosteroids improve objective sleep measures but not subjective symptoms in children with sleep-disordered breathing.
  • Mild sleep-disordered breathing, characterized by habitual snoring and a mild apnea-hypopnea index, often presents with unclear treatment benefits.
  • The efficacy of nasal corticosteroids in concurrently improving polysomnography findings and symptoms in this specific pediatric subgroup required further investigation.

Purpose of the Study:

  • To determine if a 4-week course of nasal budesonide improves both polysomnography indices and symptom scores in children with mild sleep-disordered breathing.
  • To assess the durability of treatment effects on sleep parameters and symptoms following the cessation of nasal corticosteroid administration.

Main Methods:

  • A study involving 27 children aged 2–14 years with habitual snoring and an apnea-hypopnea index of 1–10 episodes/hr.
  • Participants received budesonide 50 mcg per nostril twice daily for 4 weeks.
  • Evaluations included polysomnography and symptom scoring at baseline, 2 weeks post-treatment, and 9 months post-treatment.

Main Results:

  • Significant improvements were observed in polysomnography findings, with a decrease in the mean apnea-hypopnea index from 5.2 to 3.2 episodes/hr (P < 0.0001).
  • Median oxygen desaturation of hemoglobin index also decreased significantly from 3.1 to 1.9 (P < 0.0001).
  • Symptom scores showed a significant reduction from baseline, decreasing at 2 weeks post-treatment and remaining improved at 9 months (P < 0.05).

Conclusions:

  • Four weeks of nasal budesonide treatment is effective in improving both objective polysomnography measures and subjective symptoms in children with mild sleep-disordered breathing.
  • The beneficial clinical effects of nasal budesonide for mild sleep-disordered breathing in children are sustained for at least several months after treatment completion.
  • Nasal corticosteroids represent a viable therapeutic option for managing mild sleep-disordered breathing in pediatric populations.

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