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Published on: December 6, 2016
Montelukast for children with obstructive sleep apnea: a double-blind, placebo-controlled study
Aviv D Goldbart1, Sari Greenberg-Dotan, Asher Tal
1Department of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, POB 151, Beer Sheva, Israel. avivgold@bgu.ac.il
Insights
Montelukast significantly improved obstructive sleep apnea (OSA) in children. This 12-week treatment reduced respiratory disturbances and adenoid size, offering a new therapeutic option for pediatric OSA.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Pharmacology
Background:
- Nonsevere obstructive sleep apnea (OSA) in children can benefit from alternative therapies.
- Leukotriene modifiers are a potential intervention for pediatric OSA.
Purpose of the Study:
- To test the hypothesis that montelukast improves OSA in children.
- To evaluate montelukast's efficacy in a double-blind, randomized, placebo-controlled trial.
Main Methods:
- 46 children with diagnosed OSA were randomized to receive montelukast or placebo for 12 weeks.
- Interventions included daily oral montelukast (4 or 5 mg) or placebo.
- Assessments included polysomnography, parent questionnaires, and radiographs.
Main Results:
- Montelukast significantly improved polysomnographic measures (obstructive apnea index) compared to placebo.
- Children treated with montelukast showed reduced symptoms and smaller adenoid size.
- No adverse events or attrition were reported.
Conclusions:
- Montelukast effectively reduced OSA severity in children over 12 weeks.
- Oral montelukast also reduced adenoidal hypertrophy in pediatric patients.
- Montelukast is a viable treatment for nonsevere pediatric OSA.
Objectives:
Children with nonsevere obstructive sleep apnea (OSA) benefit from alternative therapeutic interventions such as leukotriene modifiers. We hypothesized that montelukast might improve OSA in children. We tested this hypothesis in a double-blind, randomized, placebo-controlled fashion.
Methods:
Of 50 possible candidates, we recruited 46 children with polysomnographically diagnosed OSA. In this prospective, double-blind, randomized trial, children received daily oral montelukast at 4 or 5 mg (<6 or >6 years of age, respectively) or placebo for 12 weeks. Polysomnographic assessments, parent questionnaires, and radiographs to assess adenoid size were performed before and after therapy.
Results:
Compared with the 23 children that received placebo, the 23 children that received montelukast showed significant improvements in polysomnographic measures of respiratory disturbance (obstructive apnea index), children's symptoms, and adenoid size. The obstructive apnea index decreased by >50% in 65.2% of treated children. No attrition or side effects occurred.
Conclusions:
A 12-week treatment with daily, oral montelukast effectively reduced the severity of OSA and the magnitude of the underlying adenoidal hypertrophy in children with nonsevere OSA.
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