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Control of breathing in children with mild sleep apnoea: a 6-year follow-up study

A Rice1, S Costy-Bennett, J L Goodwin

  • 1Dept of Physiology, The University of Arizona, Tucson, AZ 85721-0093, USA.

The European Respiratory Journal
|July 4, 2009
PubMed

Insights

Children with mild obstructive sleep apnea showed improved breathing and reduced CO2 retention as they grew older. This suggests natural airway development can overcome initial breathing challenges.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Children with mildly elevated obstructive apnoea/hypopnoea indices (OAHI) can retain carbon dioxide (CO2) at rest.
  • Previous research indicated impaired CO2 regulation in this pediatric group.

Purpose of the Study:

  • To investigate the long-term respiratory changes in children with mild obstructive sleep apnea over a 6-year period.
  • To assess the impact of age and somatic growth on ventilation and CO2 levels.

Main Methods:

  • Follow-up study of 14 children previously identified with mild obstructive sleep apnea.
  • Measurement of minute ventilation (V'(E)) and end-tidal CO2 partial pressure (P(ET,CO2)) during hypercapnic challenge at baseline and after 6 years.
  • Analysis of changes in OAHI and body mass index (BMI).

Main Results:

  • Obstructive apnoea/hypopnoea indices (OAHI) significantly decreased from 7.5 to 2.5 events/hr (p<0.001) by age 15.
  • Despite increased BMI, eupneic minute ventilation (V'(E)) increased (p<0.01) and end-tidal CO2 partial pressure (P(ET,CO2)) decreased (p<0.001).
  • The ventilatory response to hypercapnia shifted leftward, indicating improved CO2 clearance.

Conclusions:

  • Somatic growth of the pharynx and potential regression of tonsillar tissue may enlarge the upper airway lumen with age.
  • This leads to reduced airway resistance and increased respiratory airflow, improving CO2 regulation in children with prior mild obstructive sleep apnea.
  • The findings suggest a natural resolution of mild obstructive sleep apnea-related breathing issues through airway development.

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