Upper Airway Vibration Perception in School-Aged Children with Obstructive Sleep Apnea
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Published on: December 6, 2016
Ignacio E Tapia1,2, Ji Young Kim3, Mary Anne Cornaglia1
1Sleep Center, The Children's Hospital of Philadelphia, Philadelphia, PA.
Insights
Children with obstructive sleep apnea (OSA) do not have impaired palate vibration threshold detection (VT) compared to healthy children. Palate VT does not appear to be affected by childhood OSA, even after treatment.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Neuroscience
Background:
- Obstructive sleep apnea (OSA) in children is associated with impaired upper airway sensory function.
- Vibration threshold (VT) detection in the palate is reduced in adults with OSA, suggesting a potential afferent neural pathway defect.
- This sensory deficit has not been previously investigated in pediatric populations with OSA.
Purpose of the Study:
- To investigate whether children with OSA exhibit impaired palate vibration threshold (VT) detection compared to healthy controls.
- To determine if palate VT improves after surgical treatment for OSA in children.
Main Methods:
- A case-control study design was employed, comparing children diagnosed with OSA to healthy non-snoring controls.
- Participants underwent polysomnography and palate VT measurements.
- Children with OSA were re-evaluated post-adenotonsillectomy.
Main Results:
- Palate VT was similar between children with OSA (1.0 [0.8-1.5] vibration units) and controls (1 [0.8-1.3] vibration units; P = 0.37).
- Following adenotonsillectomy, OSA severity significantly decreased (P < 0.001), but palate VT showed no significant change (P = 0.37).
Conclusions:
- Children with OSA and healthy controls demonstrate comparable palate vibration threshold detection.
- Unlike in adults, palate VT does not appear to be adversely affected by OSA in the pediatric population.
Study Objectives:
Children with the obstructive sleep apnea (OSA) have impaired upper airway two-point discrimination compared to controls. In addition, blunted vibration threshold detection (VT) in the palate has been recognized in adults with OSA, but has not been studied in children. Both findings are indicative of a defect in the afferent limb of the upper airway dilator reflex that could prevent upper airway dilation secondary to airway loading, resulting in airway collapse. We hypothesized that children with OSA have impaired palate VT compared to controls, and that this improves after OSA treatment.
Methods:
Case-control study. Children with OSA and healthy non-snoring controls underwent polysomnography and palate VT measurements. Children with OSA were retested after adenotonsillectomy.
Results:
29 children with OSA (median [interquartile range] age = 9.5 [7.5-12.6] years, obstructive apnea-hypopnea index [OAHI] = 11.3 [5.7-19.5] events/h, BMI z = 1.8 [1.3-2.1]) and 32 controls (age = 11.2 [9.3-13.5] years, P = 0.1; OAHI = 0.5 [0.1-0.7] events/h, P < 0.001; BMI z = 1 [0.3-1.7], P = 0.004) were tested. OSA palate VT (1.0 [0.8-1.5] vibration units) was similar to that of controls (1 [0.8-1.3], P = 0.37). 20 children with OSA were retested 4.4 (3.2-7.1) months after treatment. OAHI decreased from 13.1 (5.8-19) to 0.6 (0.2-2.5) events per hour (P < 0.001) postoperatively, but palate VT did not change (before = 1 [0.7-1.5], after = 1.2 [0.8-1.4], P = 0.37).
Conclusions:
Children with OSA and controls have similar palate VT. Unlike in adults, palate VT does not seem to be affected by childhood OSA.
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