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Obstructive sleep apnea screening in children with asthma

Mudiaga O Sowho1, Rachelle Koehl1, Rebecca Shade1

  • 1Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Pediatric Pulmonology
|February 28, 2023
PubMed

Insights

Obstructive sleep apnea (OSA) is common in children with asthma. A child's body mass index z-score is a simple, effective tool for screening OSA in this population.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Asthma Research

Background:

  • Obstructive sleep apnea (OSA) is prevalent in children with asthma, especially those who are obese.
  • Current screening questionnaires for OSA in asthmatic children have limited accuracy.
  • Identifying accurate screening methods for OSA in this vulnerable population is crucial.

Purpose of the Study:

  • To identify specific questions from a sleep-related breathing disorder survey that are associated with OSA in children with asthma.
  • To evaluate the diagnostic accuracy of individual survey questions and a composite score compared to body mass index (BMI) z-score for OSA screening.

Main Methods:

  • A cohort of 136 children with asthma completed a sleep-related breathing disorder survey.
  • Polysomnography was performed to diagnose OSA (apnea-hypopnea index ≥ 2 events/h).
  • Logistic regression analyzed associations between survey questions and OSA; predictive values were calculated.

Main Results:

  • The prevalence of OSA was 40% in the study sample.
  • Loud snoring, morning dry mouth, and being overweight were significantly associated with OSA.
  • The BMI z-score alone demonstrated higher positive (76.3%) and negative (72.2%) predictive values than the composite survey score (60.3% and 77.6%).

Conclusions:

  • The body mass index z-score is a valuable and simple tool for screening obstructive sleep apnea in children with asthma.
  • Routine application of BMI z-score screening is recommended due to its effectiveness and the potential impact of OSA on asthma morbidity.
Abstract

Keywords:
asthmaobesitysleep apnea screeningsleep-disordered breathing

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