Related Experiment Video
Updated: May 3, 2026
Oral Biofilm Sampling for Microbiome Analysis in Healthy Children
Published on: December 31, 2017
Salivary biomarkers of obstructive sleep apnea syndrome in children
Francesca R Patacchioli1, Alessandra Tabarrini, Cristina M Ghiciuc
1Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy.
Insights
Children with obstructive sleep apnea (OSA) show altered hypothalamic-pituitary-adrenal (HPA) axis activity, indicated by increased salivary cortisol. This dysregulation may contribute to adverse health outcomes in pediatric OSA patients.
Area of Science:
- Pediatric Endocrinology
- Sleep Medicine
- Neuroendocrinology
Background:
- Obstructive sleep apnea (OSA) is prevalent in children and associated with various health issues.
- The hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) are crucial for stress response and physiological regulation.
- Dysregulation of these systems may play a role in the pathophysiology of pediatric OSA.
Purpose of the Study:
- To evaluate HPA axis and ANS activity in children with mild or moderate-to-severe (MS) OSA.
- To measure salivary cortisol and alpha-amylase diurnal patterns in pediatric OSA patients.
- To correlate salivary biomarker concentrations with polysomnography (PSG) variables indicative of OSA severity.
Main Methods:
- Pilot study involving 27 children with OSA (13 mild, 14 MS) and 7 healthy controls.
- Collection of salivary samples to measure cortisol and alpha-amylase levels.
- Enzyme-linked bioassays used for biomarker quantification.
Main Results:
- Children with mild and MS OSA exhibited increased diurnal salivary cortisol production compared to controls.
- The physiological circadian activity of the HPA axis was maintained in OSA children.
- No significant changes in diurnal alpha-amylase trajectory or production were observed in OSA patients.
- Morning salivary cortisol concentrations showed a negative association with disease severity in the MS OSA group.
Conclusions:
- Pediatric OSA is linked to dysregulation of HPA axis activity.
- Altered HPA axis function in children with OSA may contribute to the disease's adverse consequences.
- Further research is warranted to explore the clinical implications of HPA axis dysregulation in pediatric OSA.
Objectives:
The present pilot study was performed to evaluate the HPA axis and ANS activity by measuring salivary cortisol and α-amylase diurnal trajectory and production, respectively, in mild or moderate-to-severe (MS) OSA-affected, but otherwise healthy, children. Moreover, a correlative analysis was performed between the salivary biomarker concentrations and the PSG variables characterizing the OSA severity.
Methods:
We studied 27 consecutive OSA patients (13 mild OSA; 14 MS OSA) and seven healthy children who were enrolled as controls by collecting salivary samples and measuring cortisol and α-amylase levels using enzyme-linked bioassays.
Results:
Compared with controls, both mild and MS OSA children showed: (1) increased salivary cortisol diurnal production, (2) maintenance of the physiological circadian activity of the HPA axis, and (3) no changes in α-amylase diurnal trajectory and production. In addition, morning salivary cortisol concentrations was negatively associated with the disease severity in the MS OSA group.
Conclusions:
OSA is associated with dysregulation of the HPA axis activity in children, the latter potentially underlying some of the adverse consequences of the disease.
Related Concept Videos
01:21Sleep Apnea
The condition is more prevalent among...
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...