Obstructive sleep apnea and history of asthma in snoring children
Maya Ramagopal1, Steven M Scharf, Darryl W Roberts
1Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, University of Medicine & Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. ramagoma@umdnj.edu
Insights
In snoring children, asthma does not increase the risk of Obstructive Sleep Apnea (OSA). Surprisingly, a parent
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Medicine
- Clinical Research
Background:
- Asthma is a potential risk factor for Obstructive Sleep Apnea (OSA) in children.
- The relationship between parent-reported asthma and OSA diagnosis in snoring children requires further investigation.
Purpose of the Study:
- To determine if parent-reported asthma increases the likelihood of OSA diagnosis in snoring children.
- To investigate the association between asthma and polysomnographically diagnosed OSA in a pediatric cohort.
Main Methods:
- Retrospective review of polysomnogram (PSG) and questionnaire data from 236 children referred for snoring evaluation.
- Analysis included logistic regression to control for confounding factors.
- Demographic data, BMI percentile, and asthma history were collected.
Main Results:
- No increased risk of OSA was found in children with asthma.
- Parent-reported asthma was associated with a 34% decreased likelihood of OSA (p = 0.027), after controlling for covariates.
- Minor differences in arousal index and total sleep time were observed between asthmatic and non-asthmatic children.
Conclusions:
- Asymptomatic asthma in children referred for snoring does not increase the likelihood of Obstructive Sleep Apnea.
- Parental reporting of asthma in this cohort was unexpectedly linked to a reduced likelihood of OSA diagnosis.
- Further research is needed to understand the complex interplay between asthma, sleep, and OSA in pediatric populations.
Abstract:
Asthma has been identified as a possible risk factor for Obstructive Sleep Apnea (OSA) in children. It is not known whether parent-reported asthma increases the likelihood of the diagnosis of OSA in snoring children. We hypothesized that snoring children with asthma are more likely to have OSA than snoring children without asthma. This study is a 1-year retrospective review of polysomnogram and questionnaire data collected on 236 patients referred to the University of Maryland Pediatric Sleep laboratory for evaluation of snoring. Of the 236 patients, 58% (137/236) were boys, and 79% (173/219 reporting race) were African-American (AA). The age at referral was 7.2 +/- 3.7 years (mean +/- S.D.). Mean body mass index (BMI) percentile was 73.4 +/- 32.3%, with 43.2% (54/125) >95th percentile. A history of asthma was reported by 31.4% (74/236); no subject was symptomatic on the night of the study. We found no increased risk for polysomnographically diagnosed OSA for asthmatics. To the contrary, by logistic regression analysis, a parent/guardian report of asthma decreased the odds of having OSA by 34% (p = 0.027), controlling for individual and socioeconomic factors and assessment results. Polysomnographic (PSG) differences between asthmatic and non-asthmatic children were found in only the arousal index (11.0 vs.9.3 +/- 6.5/h, p = 0.099) and total sleep time (337.1 +/- 64.3 vs. 347 +/- 65.2 min, p = 0.1) In a referral-based group of predominantly AA inner-city snoring children, asymptomatic asthma decreased the likelihood of OSA.
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