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Obstructive Sleep Apnea in Children With Autism

Anna Tomkies1, Romaine F Johnson1, Gopi Shah1

  • 1Division of Pediatric Otolaryngology, Department of Otolaryngology, Head and Neck Surgery, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|October 10, 2019
PubMed

Insights

This study found no specific predictors for obstructive sleep apnea (OSA) in children with autism spectrum disorder (ASD). However, increased weight predicted severe OSA, suggesting general indications for polysomnography (PSG) in this population.

Area of Science:

  • Pediatric Sleep Medicine
  • Neurodevelopmental Disorders
  • Sleep Disorders

Background:

  • Autism spectrum disorder (ASD) is associated with a higher prevalence of sleep disturbances.
  • Obstructive sleep apnea (OSA) is a common sleep disorder that can exacerbate behavioral and cognitive issues in children.
  • Polysomnography (PSG) is the gold standard for diagnosing sleep apnea, but identifying specific referral criteria in ASD populations is important.

Purpose of the Study:

  • To characterize demographic and clinical features of children with ASD undergoing PSG.
  • To identify predictors of OSA and severe OSA in this cohort.
  • To inform clinical practice regarding PSG referrals for children with ASD.

Main Methods:

  • Retrospective case series of 45 children (ages 2-18) who underwent PSG.
  • Data collected included demographics, anthropometrics, tonsil size, and comorbidities.
  • Statistical analysis to evaluate predictors of OSA and severe OSA.

Main Results:

  • 58% of children with ASD had OSA, and 20% had severe OSA.
  • Obesity was present in 33% of the cohort, with higher likelihood in African American and Hispanic children.
  • No demographic or clinical factors predicted OSA, but increased weight predicted severe OSA.

Conclusions:

  • The lack of specific predictors for OSA in children with ASD supports the use of general indications for PSG.
  • Further research may explore the nuanced relationship between ASD, obesity, and sleep-disordered breathing.
  • Clinical vigilance for OSA in children with ASD, particularly those who are overweight, is warranted.
Abstract

Keywords:
autism spectrum disorderobstructive sleep apneapolysomnography

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