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Published on: December 6, 2016
Twenty-year follow-up of children with obstructive sleep apnea
Luana Nosetti1, Marco Zaffanello2, Eliot S Katz3,4
1Pediatric Sleep Disorders Center, Department of Pediatrics, F. Del Ponte Hospital, Insubria University, Varese, Italy.
Insights
Children with severe obstructive sleep apnea (OSA) face long-term risks into adulthood, including higher BMI and lower academic achievement. Early OSA diagnosis is crucial for preventing chronic diseases later in life.
Area of Science:
- Pediatric Sleep Medicine
- Cardiovascular Health
- Neurodevelopmental Disorders
Background:
- Childhood obstructive sleep apnea (OSA) is linked to immediate metabolic, cardiovascular, and neurocognitive issues.
- The long-term health consequences of pediatric OSA into adulthood remain largely unestablished.
Purpose of the Study:
- To evaluate the long-term anthropometric, sleep, cognitive, and cardiovascular outcomes in adults with a history of childhood OSA.
- To compare these outcomes with a healthy control group over a 20-year follow-up period.
Main Methods:
- A 20-year prospective follow-up study involving patients diagnosed with severe OSA in childhood (ages 1-17).
- Data collection included anthropometric information, educational attainment, health history, and Berlin questionnaire scores via telephone interviews in adulthood.
- Comparison was made against a healthy control group.
Main Results:
- Young adults with a history of severe childhood OSA exhibited significantly higher adult body mass index (BMI) (P = .038).
- They also had lower academic achievement (fewer degrees) (P < .001) and increased reported snoring (P = .045) compared to controls.
- Childhood apnea-hypopnea index showed a trend towards predicting adult cardiovascular outcomes and questionnaire results.
Conclusions:
- Adults with a history of severe childhood OSA are at elevated risk for persistent snoring, obesity, and reduced academic success.
- These findings suggest that severe childhood OSA may predispose individuals to chronic diseases in later life.
- The COVID-19 pandemic has complicated the assessment of long-term OSA consequences due to additional neurobehavioral impacts.
Study Objectives:
Obstructive sleep apnea (OSA) in children is associated with acute metabolic, cardiovascular, and neurocognitive abnormalities. The long-term outcomes of childhood OSA into adulthood have not been established. We performed a 20-year follow-up of patients with polysomnography-documented OSA in childhood compared to a healthy control group to evaluate the long-term anthropometric, sleep, cognitive, and cardiovascular outcomes.
Methods:
Children diagnosed with severe OSA between ages 1 and 17 years (mean, 4.87 ± 2.77) were prospectively contacted by telephone as young adults after approximately 20 years. Data collected included reported anthropometric information, educational level, health history, and Berlin questionnaire scores.
Results:
Young adults with confirmed severe OSA in childhood had significantly higher adulthood body mass index (P = .038), fewer academic degrees (P < .001), and more snoring (P = .045) compared to control patients. The apnea-hypopnea index during childhood trended toward predicting cardiovascular outcomes and the results of the Berlin questionnaire in adulthood.
Conclusions:
Adults with a history of severe childhood OSA have a high risk of snoring, elevated body mass index, and lower academic achievement in adulthood. Thus, children with severe OSA may be at increased risk of chronic diseases later in life. The intervening coronavirus disease 2019 (COVID-19) pandemic has introduced considerable additional neurobehavioral morbidity complicating the identification of the full long-term consequences of childhood OSA.
Citation:
Nosetti L, Zaffanello M, Katz ES, et al. Twenty-year follow-up of children with obstructive sleep apnea. J Clin Sleep Med. 2022;18(6):1573-1581.
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