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Utilizing inspiratory airflows during standard polysomnography to assess pharyngeal function in children during sleep

Brian M McGinley1, Jason P Kirkness2, Hartmut Schneider2

  • 1Division of Pediatric Pulmonary and Sleep Medicine, University of Utah, Salt Lake City, Utah.

Pediatric Pulmonology
|October 17, 2015
PubMed

Insights

Children with obstructive sleep apnea (OSA) experience worse upper airway obstruction during REM sleep compared to snoring children. Adenotonsillectomy significantly improved these breathing issues in children with OSA.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnea (OSA) in children is characterized by pharyngeal obstruction, primarily during REM sleep.
  • The precise mechanisms underlying upper airway obstruction in pediatric OSA remain poorly understood.
  • Understanding these mechanisms is crucial for effective diagnosis and treatment.

Purpose of the Study:

  • To compare upper airway obstruction in children with OSA versus those who snore during sleep.
  • To investigate the differences in obstruction severity between REM and non-REM sleep stages.
  • To evaluate the impact of adenotonsillectomy on upper airway obstruction in children with OSA.

Main Methods:

  • Polysomnography was performed on children with OSA before and after adenotonsillectomy.
  • Children with OSA were compared to age-, gender-, and BMI-matched snoring children.
  • Upper airway obstruction was quantified using maximal inspiratory airflow (%VI max) and % time with inspiratory flow-limited breathing (%IFL).

Main Results:

  • Children with OSA showed similar non-REM obstruction but significantly higher %IFL and lower %VI max during REM sleep compared to snoring children.
  • Elevated CO2 levels were observed in children with OSA during both wakefulness and sleep.
  • Adenotonsillectomy led to improved REM sleep obstruction, evidenced by decreased %IFL, increased %VI max, and reduced CO2 levels.

Conclusions:

  • Children with OSA exhibit impaired compensatory responses during REM sleep, leading to increased upper airway obstruction.
  • These findings highlight the specific challenges of REM sleep in pediatric OSA.
  • Adenotonsillectomy effectively alleviates upper airway obstruction in children with OSA, particularly during REM sleep.
Abstract

Keywords:
adenotonsillectomycompensatory responses to sleep apneaobstructive sleep apnea

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