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Assessment of Central Sleep Apnea Events in Children with Sleep-Disordered Breathing

Alyson Kaplan1, Seckin O Ulualp1,2

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Sleep Disorders
|May 27, 2022
PubMed

Insights

Central sleep apnea (CSA) is common in children with sleep-disordered breathing (SDB). Tonsillectomy and adenoidectomy (TA) improved both obstructive sleep apnea (OSA) and CSA in these children.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Sleep-disordered breathing (SDB) is a common condition in children.
  • Central sleep apnea (CSA) is a less understood component of SDB.
  • The impact of tonsillectomy and adenoidectomy (TA) on CSA in children with obstructive sleep apnea (OSA) requires further investigation.

Purpose of the Study:

  • To determine the prevalence of central apnea (CA) events and CSA in children with SDB.
  • To assess the effect of TA on CSA in children with OSA.
  • To evaluate factors influencing CSA prevalence, including age, gender, obesity, and comorbidities.

Main Methods:

  • Retrospective review of medical charts for children with SDB.
  • Analysis of polysomnography (PSG) findings, including CA events, obstructive apnea-hypopnea index (OAHI), and central apnea index (CAI).
  • Comparison of respiratory parameters before and after TA in children who underwent the procedure.

Main Results:

  • CA events were observed in 89.5% of 712 children with SDB.
  • CSA was diagnosed in 44.2% of children with SDB and was more prevalent in younger children and those with obesity.
  • Following TA, significant improvements were noted in CA events, CAI, and OAHI (p < 0.001), although residual CSA was present in 26% of patients.

Conclusions:

  • Central apnea events and CSA are prevalent in children evaluated for SDB in pediatric otolaryngology clinics.
  • Both CSA and OSA demonstrate improvement after tonsillectomy and adenoidectomy.
  • TA is an effective treatment for improving SDB, including central sleep apnea, in pediatric patients.
Abstract

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