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Airway Resistance in Children with Obstructive Sleep Apnea Syndrome

Ignacio E Tapia1, Carole L Marcus1, Joseph M McDonough2

  • 1Sleep Center, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Sleep
|December 31, 2015
PubMed

Insights

Children with obstructive sleep apnea syndrome (OSAS) have higher airway resistance (AR) during wakefulness. Treatment for OSAS significantly reduces this elevated AR, suggesting a link between upper airway obstruction and breathing difficulties.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Enlarged tonsils and adenoids are primary causes of obstructive sleep apnea syndrome (OSAS) in children, leading to upper airway (UA) loading.
  • This UA loading can disrupt the balance between structural and neuromotor factors, causing UA collapse during sleep.
  • The impact of UA loading on airway resistance (AR) during wakefulness in children with OSAS is not well understood.

Purpose of the Study:

  • To investigate whether children with OSAS exhibit elevated AR during wakefulness compared to healthy controls.
  • To determine if AR improves after treatment for OSAS in children.

Main Methods:

  • A case-control study involving children with OSAS and healthy controls.
  • Baseline polysomnography, spirometry, and AR measurement using body plethysmography with an orofacial mask.
  • Children with OSAS underwent repeat testing after adenotonsillectomy.

Main Results:

  • Children with OSAS showed significantly higher baseline AR (3.9 cmH2O/L/sec) compared to controls (2.8 cmH2O/L/sec).
  • Spirometry results were similar between the OSAS and control groups.
  • Following adenotonsillectomy, OSAS patients experienced a significant decrease in AR (from 4.3 to 2.8 cmH2O/L/sec).

Conclusions:

  • Children diagnosed with OSAS present with elevated AR during wakefulness.
  • Adenotonsillectomy effectively reduces AR in children with OSAS.
  • Elevated AR in OSAS may be attributed to upper airway loading from adenotonsillar hypertrophy and could contribute to respiratory issues.
Abstract

Keywords:
OSASairway resistancechildren

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