Sleep apnea as common as asthma in German kids
A new German study suggests that about 3 percent of school-age children may have the nighttime breathing disorder sleep apnea—similar to the country’s rate of childhood asthma.
The findings suggest that there needs to be greater awareness of sleep apnea as a problem among children, researchers report in the European Respiratory Journal.
Obstructive sleep apnea, or OSA, occurs when the soft tissues at the back of the throat temporarily collapse during sleep, causing repeated breathing interruptions. The major symptoms include loud snoring and daytime sleepiness owing to a lack of deep sleep at night.
In children, the disorder often stems from enlarged tonsils or adenoids, and surgical removal of the tissue may resolve the problem in those cases.
The prevalence of OSA among children in this study was somewhat higher than expected, lead researcher Dr. Michael S. Urschitz, of the University Children’s Hospital Tuebingen in Germany, told Reuters Health in an email.
The rate among study participants—2.8 percent—suggests that OSA is one of the most common respiratory ills among elementary school-age children, Urschitz and his colleagues write.
By comparison, they note, a recent study of German children and teenagers found that 3 percent suffered from asthma over one year.
For their study, Urschitz and his colleagues screened 1,044 third-graders from the city of Hanover for OSA symptoms.
Using parent questionnaires and a test called pulse oximetry—which non-invasively measured the children’s blood oxygen levels overnight—the researchers found that 169 had signs or symptoms suggestive of OSA.
Of those children, 132 underwent home-based polysomnography, in which a portable device is used to measure airflow, blood oxygen levels, snoring and other activities as a person sleeps. Another 51 children who had screened negative for OSA also underwent polysomnography.
Based on those sleep studies, 22 children were diagnosed with OSA. The researchers also developed a way to predict OSA based on the screening results and whether children had certain characteristics associated with OSA, like heavier weight or a history of allergies. They applied that model to the children who had not undergone a sleep study, and diagnosed another nine cases of OSA.
The overall rate of OSA of 2.8 percent is “very close” to that seen in a 2003 study of U.S. children, which uncovered a rate of 2.2 percent, Urschitz and his colleagues note.
It is also nearly identical to the 3 percent asthma rate found among German children.
The implication, they say, is that doctors may need to give more consideration to the possibility of OSA in children with certain symptoms.
Along with snoring and daytime sleepiness, other possible signs of OSA include mouth breathing and problems with attention and behavior at school—though those problems can also be indicative of other common childhood conditions, like allergies or attention-deficit hyperactivity disorder.
A sleep study is considered the gold standard for diagnosing OSA. But, Urschitz said, in some cases, a child’s symptoms, medical history and an ear-nose-throat examination may be enough.
SOURCE: European Respiratory Journal, online March 11, 2010.
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