Positional obstructive sleep apnea in children: prevalence and risk factors

Area of Science:

• Pediatric Sleep Medicine
• Respiratory Medicine
• Otolaryngology

Background:

• Positional obstructive sleep apnea (POSA) is a significant subtype of obstructive sleep apnea (OSA), affecting a majority of adult OSA patients.
• Understanding the prevalence and characteristics of POSA in pediatric populations is crucial for accurate diagnosis and management.

Purpose of the Study:

• To determine the prevalence of positional obstructive sleep apnea (POSA) in children diagnosed with moderate to severe obstructive sleep apnea (OSA).
• To identify potential risk factors associated with POSA in the pediatric population.

Main Methods:

• A cross-sectional analysis was conducted on data from 171 children with moderate to severe OSA, confirmed by polysomnography (PSG).
• POSA was defined as an obstructive apnea-hypopnea index (oAHI) in the supine position being at least twice the oAHI in the non-supine position.

Main Results:

• The prevalence of POSA among the studied children was 18.7%.
• Children with POSA were significantly older, had a higher prevalence of obesity, lower tonsil scores, and less severe OSA compared to those without POSA.
• Age was identified as the sole significant independent predictor of POSA in this cohort.

Conclusions:

• Positional obstructive sleep apnea (POSA) is less prevalent in children than in adults, with its occurrence increasing with age.
• Unlike general OSA, POSA severity did not show a significant worsening during REM sleep in children.
• Further research is recommended to explore POSA prevalence in specific pediatric subgroups and to investigate upper airway characteristics in children with POSA.