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Obstructive sleep apnea in developmental age. A narrative review.
Anna Lo Bue1, Adriana Salvaggio2, Giuseppe Insalaco2
1National Research Council of Italy, Institute for Biomedical Research and Innovation, Via Ugo La Malfa, 153, 90146, Palermo, Italy. anna.lobue@irib.cnr.it.
European Journal of Pediatrics
|January 16, 2020
Summary
Obstructive sleep apnea (OSA) in children differs significantly from adults, impacting developing brains more severely. Prompt diagnosis and treatment are crucial to prevent long-term neurocognitive and physical deficits in children.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
- Respiratory Physiology
Background:
- Sleep undergoes significant neurophysiological and behavioral variations across different life stages.
- Childhood development involves continuous physical, neuropsychological changes, and synaptic remodeling during sleep, underpinning brain plasticity.
- Obstructive sleep apnea (OSA) in children presents unique characteristics compared to adults, with diagnostic criteria differing significantly.
Purpose of the Study:
- To provide a narrative review of obstructive sleep apnea (OSA) in developmental age.
- To highlight the variability and age-specific nature of pediatric OSA.
- To compare and analyze OSA across different age groups throughout life.
Main Methods:
- This study is a narrative review.
- It synthesizes existing literature on obstructive sleep apnea in developmental age.
- The review compares clinical manifestations, diagnostic, and therapeutic criteria across pediatric and adult populations.
Main Results:
- Adenotonsillar hypertrophy is a primary risk factor for pediatric OSA, with obesity increasingly prevalent, especially in early childhood and adolescence.
- OSA significantly affects cognitive function in children, potentially altering neuro-psychic development, learning, and social interactions due to its impact on plastic brain structures.
- Diagnostic thresholds for OSA, such as an apnea-hypopnea index (AHI) of 5, differ between pediatric and adult populations, with a lower threshold in children indicating a need for therapeutic intervention.
Conclusions:
- Obstructive sleep apnea (OSA) is a prevalent disorder in children requiring prompt identification and management.
- Untreated pediatric OSA can lead to serious cardiovascular, metabolic, and neurocognitive morbidities.
- Early intervention is critical to prevent potentially irreversible deficits during crucial developmental periods.
