Obstructive sleep apnea in asthmatic children: highly prevalent though
no identifiable risk factors
Abstract
Rationale: Obstructive sleep apnea and asthma often coexist;
besides, they share a bidirectional influence towards the other
condition. In adults, obstructive sleep apnea is more prevalent in men
and asthma in women. However, during childhood, obstructive sleep apnea
prevalence is equal in boys and girls while asthma has a strong
influence of puberty in its prevalence, with pubescent girls more
affected than boys. Objectives: To analyze the prevalence of
obstructive sleep apnea in: 1) boys and girls and 2) severe asthma
versus moderate and mild cases. We hypothesized that girls and severe
asthma would have a higher prevalence of obstructive sleep apnea.
Methods: Cross-sectional evaluation of asthmatic children
attending a tertiary Pediatric Pulmonology clinic.
Measurements: History, physical examination, Pulmonary Function
Test, and Home Sleep Apnea Test. Main Results: We studied 80
consecutive patients, 7 to 18 years-old, mean age 11.6 years (standard
deviation 2.7), 51.3% female, and 18.5% obese. Pulmonary Function
Tests were obtained from 71 volunteers, 45% with obstruction pattern.
Home Sleep Apnea Tests were available from 76 volunteers, with mean
obstructive respiratory index of 1.8 events/h. Obstructive sleep apnea
was found in 69 volunteers (86.2%). We did not find associations of
obstructive sleep apnea and sex or asthma severity.
Conclusions: Obstructive sleep apnea was frequent among these
asthmatic children. Sex and asthma severity were not risk factors.
Considering the interrelationship of both diseases, it is worth to keep
in mind the possibility of obstructive sleep apnea among children and
teenagers with asthma.