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Positional obstructive sleep apnea in children: prevalence and risk factors

E Verhelst1, I Clinck2, I Deboutte2

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.

Sleep & Breathing = Schlaf & Atmung
|May 9, 2019
PubMed

Insights

Positional obstructive sleep apnea (POSA) affects 18.7% of children with obstructive sleep apnea (OSA). Older age is the main predictor, and POSA is less common in children than adults.

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.
Abstract

Keywords:
ChildrenObstructive sleep apneaPolysomnographySleep position

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