OSA in children tends to persist

January 01, 0001

OSA in children tends to persist

Obstructive sleep apnea (OSA) is a growing problem worldwide, and is increasingly an issue in pediatric populations. These Chinese researchers examined the natural history of mild childhood OSA and identified factors linked with progression. The first 56 consecutive children identified with incident mild OSA in a Chinese epidemiological study were asked to participate in a repeat assessment 2 years later.

The researchers found: "45 children participated in the follow-up study, in 13 of whom (29%) the OSA was found to have worsened. Compared with those in whom OSA had not worsened, the worsened OSA group had a greater increase in waist circumference, a higher prevalence of large tonsils (occupying =50% of the airway) at both baseline and follow-up, and a higher prevalence of habitual snoring at both baseline and follow-up. The presence of large tonsils had a positive predictive value of 53% and a negative predictive value of 83% for worsening OSA over a 2-year period. Multivariate linear regression analysis showed that the change in obstructive apnoea-hypopnoea index was associated with age at baseline (beta=-0.92), gender (beta=4.69), presence of large tonsils at baseline (beta=4.36), change in waist circumference (beta=0.30) and persistently large tonsils (beta=5.69) over the 2-year period."

They concluded: "Mild OSA in the majority of children does not resolve spontaneously. Subjects with tonsillar hypertrophy, especially boys, should be closely monitored to allow early detection of worsening OSA. Weight control should be stressed in the management of childhood OSA."

This small observational study helps to characterize the course of childhood obstructive sleep apnea

For the full abstract, click here.

Thorax 65:4-5, January 2010 © 2009 BMJ Publishing Group Ltd & British Thoracic Society
Natural history and predictors for progression of mild childhood obstructive sleep apnoea. A M Li, C T Au, S K Ng, et al.. Correspondence to A M Li: [email protected]

Category: R Respiratory Keywords: OSA, obstructive sleep apnea, tonsils, weight, waist circumference, observational study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 19 March 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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