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Updated: Jun 17, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

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Age-related Variation in Sleep-dependent Obstruction in Surgically Naive Children

Erica McArdle1, John Dewey1, Ruifeng Cui1

  • 1Department of Otolaryngology - Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, U.S.A.

The Laryngoscope
|August 13, 2024
PubMed

Insights

Older children with obstructive sleep apnea (OSA) show increased airway obstruction severity and more affected sites compared to younger children. These findings highlight age-related differences in obstruction patterns, crucial for effective pediatric OSA management.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Obstructive sleep apnea (OSA) and obstructive sleep-disordered breathing (oSDB) are common in children.
  • Age-related variations in the location and severity of airway obstruction during sleep are not well understood.
  • Drug-induced sleep endoscopy (DISE) is a key tool for evaluating airway obstruction in pediatric OSA/oSDB.

Purpose of the Study:

  • To investigate age-related differences in the sites and severity of sleep-dependent airway obstruction in surgically naive children with OSA/oSDB.
  • To compare obstruction patterns across distinct pediatric age groups using DISE findings.

Main Methods:

  • Retrospective chart review of 252 surgically naive children (0-18 years) with OSA/oSDB who underwent DISE.
  • Children were categorized into six age groups: infants, younger toddlers, older toddlers, preschool, younger school-aged, and older school-aged.
  • Obstruction was graded (none/mild, moderate, severe) at multiple airway sites, and multiple regression analyses identified age-related differences.

Main Results:

  • Older children exhibited significantly higher total obstruction scores and a greater number of severely obstructed sites.
  • Increased obstruction was observed in older groups at the inferior turbinates, adenoid, palatine tonsils/lateral pharyngeal wall, lingual tonsil, and tongue base.
  • Younger age groups showed more obstruction in the supra-arytenoid tissue.

Conclusions:

  • Significant age-dependent variations exist in the patterns and severity of airway obstruction in children with OSA/oSDB.
  • These findings underscore the importance of considering age when interpreting DISE results and tailoring treatment strategies for pediatric OSA/oSDB.
Abstract

Keywords:
agechildrendrug‐induced sleep endoscopyobstructive sleep apneasleep‐disordered breathing

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