Obstructive sleep apnea and history of asthma in snoring children

Abstract

Asthma has been identified as a possible risk factor for Obstructive Sleep Apnea (OSA) in children. It is not known whether parent-reported asthma increases the likelihood of the diagnosis of OSA in snoring children. We hypothesized that snoring children with asthma are more likely to have OSA than snoring children without asthma. This study is a 1-year retrospective review of polysomnogram and questionnaire data collected on 236 patients referred to the University of Maryland Pediatric Sleep laboratory for evaluation of snoring. Of the 236 patients, 58% (137/236) were boys, and 79% (173/219 reporting race) were African-American (AA). The age at referral was 7.2±3.7 years (mean±S.D.). Mean body mass index (BMI) percentile was 73.4±32.3%, with 43.2% (54/125) >95th percentile. A history of asthma was reported by 31.4% (74/ 236); no subject was symptomatic on the night of the study. We found no increased risk for polysomnographically diagnosed OSA for asthmatics. To the contrary, by logistic regression analysis, a parent/guardian report of asthma decreased the odds of having OSA by 34% (p=0.027), controlling for individual and socioeconomic factors and assessment results. Polysomnographic (PSG) differences between asthmatic and non-asthmatic children were found in only the arousal index (11.0 vs.9.3±6.5/h, p=0.099) and total sleep time (337.1± 64.3 vs. 347±65.2 min, p=0.1) In a referral-based group of predominantly AA inner-city snoring children, asymptomatic asthma decreased the likelihood of OSA.

Elevated economic burden in obstructive lung disease patients with concomitant sleep apnea syndrome

“…3 Means of annualized medical cost by cohort and by diagnosed sleep apnea syndrome. Predictions adjusted for age, gender, race, obesity, Charlson Comorbidity Index, and days in cohort between SAS and asthma has been suggested by some [9,19], in children, Ramagopal et al [20] found that asthma was actually a negative predictor of SAS. In our sample of middle-aged adults, there are three other possible explanations for the low prevalence of SAS among beneficiaries with asthma.…”

Body Mass Index-Percentile and Diagnostic Accuracy of Childhood Asthma

“…The underlying mechanism for the obesity-asthma link remains controversial. Factors stemming from obesity including greater systemic inflammation (36)(37)(38)(39), gastro-esophageal reflux (40)(41)(42)(43), obstructive sleep apnea (44)(45)(46), and reduced lung volumes (47,48) 47;48 are all plausible mechanisms. In addition, it is unclear how accurately and consistently various physicians diagnose asthma (49).…”

Role of Adenoidectomy in Otitis Media and Respiratory Function

“…Asthma has been identified as a risk factor for childhood obstructive sleep apnea (OSA), which is more common in overweight children [27]. Overweight without sleepdisordered breathing is not associated with increased airway inflammation [28].…”