Obstructive Sleep Apnea in Children With Autism

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.