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Features of Obstructive Sleep Apnea in Children with and without Comorbidities

Eusebi Chiner1, Jose N Sancho-Chust1, Esther Pastor1

  • 1Pulmonology Department, Multidisciplinary Sleep Clinic, San Juan de Alicante University Hospital, 03550 Alicante, Spain.

Journal of Clinical Medicine
|March 29, 2023
PubMed

Insights

Children with obstructive sleep apnea (OSA) and comorbidities often have obesity and facial anomalies, requiring combined treatments like ventilation and surgery. Group A (adenotonsillar hypertrophy) showed better outcomes than Group B (comorbidities).

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Genetics and Genomics

Background:

  • Obstructive sleep apnea (OSA) in children presents diverse clinical and polysomnographic features.
  • Distinguishing OSA in children with adenotonsillar hypertrophy versus those with comorbidities is crucial for tailored management.

Purpose of the Study:

  • To compare clinical and polysomnographic characteristics of pediatric obstructive sleep apnea (OSA).
  • To evaluate differences between children with OSA due to adenotonsillar hypertrophy (Group A) and those with comorbidities (Group B).

Main Methods:

  • A five-year prospective study involving 168 children diagnosed with OSA.
  • Nocturnal polysomnography was conducted before and after therapeutic interventions.
  • Patients were categorized into Group A (adenotonsillar hypertrophy) and Group B (comorbidities).

Main Results:

  • Group B patients were older, had higher BMIs and neck circumferences, and a greater prevalence of obesity compared to Group A.
  • Facial anomalies, macroglossia, dolichocephaly, micrognathia, and prognathism were significantly more common in Group B.
  • Adenotonsillectomy was performed more frequently in Group A, while Group B required more ventilation (CPAP/BiPAP) and maxillofacial surgery; both groups improved, but Group A showed better outcomes.

Conclusions:

  • Pediatric OSA patients with comorbidities (Group B) exhibit higher rates of obesity and facial anomalies.
  • These children often necessitate combination therapies, including positive airway pressure ventilation and surgical interventions.
  • While treatment improves outcomes in both groups, children with isolated adenotonsillar hypertrophy (Group A) tend to achieve better results.
Abstract

Keywords:
adenotonsillar hypertrophychildhood sleep apneaconcomitant diseasepredisposing factors

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