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Ventilatory responses during wakefulness in children with obstructive sleep apnea
1Division of Neonatology and Pediatric Pulmonology, Childrens Hospital Los Angeles, University of Southern California School of Medicine 90027.
Summary
Children with obstructive sleep apnea syndrome (OSAS) show normal breathing responses to high carbon dioxide and low oxygen levels. This suggests that abnormal central ventilatory drive is unlikely to cause pediatric OSAS.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive sleep apnea syndrome (OSAS) in children is often linked to tonsilloadenoidal hypertrophy.
- However, not all children with this condition develop OSAS, indicating other contributing factors.
- Abnormalities in ventilatory control are hypothesized to play a role in OSAS etiology.
Purpose of the Study:
- To investigate the role of ventilatory control abnormalities in the pathophysiology of pediatric OSAS.
- To compare hypercapnic and hypoxic ventilatory responses in children with and without OSAS.
Main Methods:
- Polysomnography was conducted on 20 children with OSAS and 19 controls.
- Hypercapnic and hypoxic ventilatory responses were measured using rebreathing techniques.
- Ventilatory responses were corrected for body surface area.
Main Results:
- Children with OSAS exhibited normal hypercapnic ventilatory response slopes compared to controls.
- Hypoxic ventilatory responses were also similar between children with OSAS and controls, though the sample size for this measure was small.
- A weak inverse correlation was found between hypercapnic response slope and hypoventilation duration during sleep.
Conclusions:
- Pediatric OSAS patients demonstrate normal ventilatory responses to both hypercapnia and hypoxia.
- Abnormal central ventilatory drive appears to play a minimal role in the pathogenesis of OSAS in children.
- Further research may be needed to fully elucidate the multifactorial causes of pediatric OSAS.