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Published on: December 6, 2016
Vitamin D Deficiency and Pediatric Obstructive Sleep Apnea Severity
Andrew E Bluher1,2, Timothy Kearney3, Turaj Vazifedan4
1Division of Pediatric Otolaryngology, Nemours Children's Hospital, Wilmington, Delaware.
Insights
Vitamin D deficiency is common in children with severe obstructive sleep apnea (OSA) and is linked to worse OSA severity. Further research is needed on vitamin D supplementation for pediatric OSA.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Nutritional Science
Background:
- Emerging evidence suggests a link between vitamin D deficiency and obstructive sleep apnea (OSA) in adults.
- The association between vitamin D levels and pediatric OSA is less understood.
- Vitamin D deficiency is a potential factor influencing OSA severity in children.
Purpose of the Study:
- To investigate the association between serum vitamin D levels and the severity of obstructive sleep apnea (OSA) in children.
- To evaluate the correlation between vitamin D deficiency and the Apnea-Hypopnea Index (AHI) in pediatric OSA patients.
Main Methods:
- Cross-sectional study of 72 children (aged 2-16 years) with severe OSA (AHI ≥20) undergoing adenotonsillectomy.
- Serum 25-hydroxyvitamin D (25[OH]D) levels were measured; deficiency defined as <20 ng/mL.
- Statistical analyses, including univariate and multivariable models, assessed the association between vitamin D levels and AHI, controlling for age, sex, race, BMI, asthma, and season.
Main Results:
- Vitamin D deficiency was prevalent in 37.5% of the participants.
- Vitamin D deficiency was associated with younger age, Black race, female sex, and higher AHI in univariate analysis.
- Multivariable analysis confirmed a significant association between lower vitamin D levels and increased AHI (0.7 increase in AHI per 1.0 unit decrease in 25[OH]D).
Conclusions:
- Vitamin D deficiency is common in children with severe OSA and significantly associated with increased OSA severity.
- These findings highlight the importance of assessing vitamin D status in pediatric OSA.
- Further research into vitamin D supplementation as an adjunct therapy for pediatric OSA is warranted.
Importance:
Prior research has demonstrated an association between vitamin D deficiency and obstructive sleep apnea (OSA) in adults; however, its association with pediatric OSA is emerging.
Objective:
To evaluate the association of vitamin D levels with obstructive Apnea-Hypopnea Index (AHI) in children with OSA.
Design, Settings, And Participants:
This was a cross-sectional study of children aged 2 to 16 years with severe obstructive OSA (AHI ≥20 on polysomnogram) who were undergoing adenotonsillectomy at a tertiary care pediatric otolaryngology clinic from 2017 to 2022. Age, sex, race, body mass index, history of asthma, and season were considered in the analyses. Data were analyzed from September 3, 2021, to October 8, 2021.
Main Outcomes And Measures:
Serum 25-hydroxyvitamin D (25[OH]D) levels were measured and assessed for correlation with polysomnography metrics. Fasting blood samples were collected and vitamin D deficiency was defined as 25(OH)D level less than 20 ng/mL.
Results:
The consecutive sample included 72 patients (mean [SD] age, 6.7 [3.9] years; 34 [47.2%] females and 38 [52.8%] males). The mean (SD) AHI was 42.8 (25.5), and 35 participants (49.0%) had obesity. Vitamin D deficiency was present in 27 participants (37.5%). In univariate analysis, vitamin D deficiency was associated with younger age (difference, -5.0; 95% CI, -7.2 to -2.8), Black race (odds ratio [OR], 4.3; 95% CI, 1.4 to 14.3), female sex (OR, 4.8; 95% CI, 1.7 to 12.5), and higher obstructive AHI (difference, 13.8; 95% CI, 1.2 to 26.4). In multivariable analysis, vitamin D deficiency remained significantly associated with AHI. A 1.0-unit decrease in serum 25(OH)D levels was associated with an AHI increase of 0.7 (95% CI, 0.04 to 1.40).
Conclusions:
The findings of this cross-sectional study indicate that vitamin D deficiency was common in children undergoing adenotonsillectomy for severe OSA and is significantly associated with increased OSA severity. Future research is needed on vitamin D supplementation and its association with any improvements in pediatric OSA treatment outcomes.
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