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Analysis of polysomnogram findings in children with concurrent obstructive and central sleep apnea

Chaewon Hwang1, Maya Ramagopal2, Kelvin Kwong3

  • 1Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA.

Laryngoscope Investigative Otolaryngology
|December 23, 2021
PubMed

Insights

Children with both obstructive sleep apnea (OSA) and central sleep apnea (CSA) are younger and experience more respiratory arousals and obstructive events. Their sleep patterns, including REM sleep, also differ from those with OSA alone.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Medicine
  • Sleep Disorders

Background:

  • Obstructive sleep apnea (OSA) and central sleep apnea (CSA) share overlapping pathophysiological mechanisms.
  • Understanding the differences and similarities in pediatric patients with concurrent OSA and CSA is crucial for diagnosis and treatment.

Purpose of the Study:

  • To compare patient characteristics and polysomnographic findings in children with concurrent obstructive sleep apnea and central sleep apnea (OSA + CSA) versus those with OSA only.

Main Methods:

  • Retrospective analysis of polysomnogram (PSG) data from patients 18 years and younger.
  • Comparison of two groups: OSA only and OSA + CSA (subdivided by central apnea index).
  • Statistical assessment of differences in age, BMI percentile, comorbidities, and PSG parameters.

Main Results:

  • Children with OSA + CSA were significantly younger (mean age 5.0 years) than those with OSA only (mean age 8.2 years).
  • No significant difference in BMI percentiles between the groups.
  • Patients with OSA + CSA exhibited higher respiratory arousals, higher obstructive apnea-hypopnea index, and increased REM sleep compared to the OSA only group.

Conclusions:

  • Concurrent OSA + CSA in children is associated with younger age and distinct sleep architecture, including higher REM sleep percentage.
  • Significantly higher respiratory arousals and obstructive events are observed in children with OSA + CSA.
  • Findings suggest overlapping mechanisms between CSA and OSA in this pediatric cohort.
Abstract

Keywords:
arousals due to respiratory eventscentral sleep apneaobstructive sleep apneapediatric sleep disorderspolysomnogram

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