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Nocturnal phenotypical features of obstructive sleep apnea (OSA) in asthmatic children

Maria J Gutierrez1, Junjia Zhu, Carlos E Rodriguez-Martinez

  • 1Division of Pulmonary, Allergy & Immunology and Critical Care Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033-0850, USA.

Pediatric Pulmonology
|December 4, 2012
PubMed

Insights

Childhood asthma is linked to more severe obstructive sleep apnea (OSA) during REM sleep, independent of asthma control or obesity. This suggests a distinct OSA phenotype in asthmatic children requiring further investigation.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Medicine
  • Clinical Pediatrics

Background:

  • Childhood asthma and obstructive sleep apnea (OSA) frequently coexist.
  • Investigating the specific phenotype of OSA in children with asthma is crucial for understanding this association.
  • A distinct OSA phenotype in asthmatic children, particularly related to Rapid-Eye-Movement (REM) sleep, was hypothesized.

Purpose of the Study:

  • To investigate the phenotypical features of OSA in children with coexisting asthma.
  • To determine if asthmatic children exhibit a unique OSA profile compared to non-asthmatic children with OSA.
  • To identify specific sleep-related breathing abnormalities associated with asthma in pediatric OSA patients.

Main Methods:

  • Retrospective cross-sectional analysis of 141 children (aged 2-12 years) diagnosed with OSA via polysomnography (PSG).
  • Evaluation of PSG parameters, including maximal oxygen saturation (SaO2) during REM desaturations and prevalence of REM-related OSA.
  • Multivariate regression models were used to analyze the association between asthma and OSA parameters, controlling for confounders.

Main Results:

  • Asthma did not affect baseline respiratory parameters or OSA severity (apnea-hypopnea index) during non-REM sleep.
  • Children with moderate-to-severe OSA and asthma showed significantly increased maximal SaO2 REM desaturation and REM-related OSA prevalence.
  • The association between asthma and REM-related OSA was independent of asthma control, BMI, age, gender, rhinitis, or atopic status.

Conclusions:

  • Asthma is significantly associated with REM-related breathing abnormalities in children with moderate-to-severe OSA.
  • This link between asthma and REM-related OSA is not influenced by asthma control or obesity.
  • Further research is warranted to elucidate the underlying REM-sleep biological mechanisms driving this distinct OSA phenotype in asthmatic children.
Abstract

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