sleep disordered breathing and snoring in childrenSleep disturbances are nowadays a public health concern throughout the world. They affect millions of people, and their prevalence is increasing not only in adults but also in children. Sleep-disordered breathing (SDB) is one of the most common sleep disturbances; it represents a continuum of symptoms from simple snoring to obstructive sleep apnea syndrome (OSAS). While the prevalence of obstructive sleep apnea in adults is 2–10 %, the prevalence of snoring is much higher. The prevalence of obstructive sleep apnea among children and adolescents has been reported to range between 1 and 3 % and that of snoring between 7 and 25 %.

It is alarming that overweight and obesity are becoming more common in children and adolescents in many developed countries. A recent report revealed that 10 % of children and 26 % of adolescents are overweight in Finland. Excess body fat is a well-recognized risk factor for Sleep-disordered breathing in adults, but it has also been proposed to be an important risk factor for paediatric Sleep-disordered breathing . In children, traditional risk factors for Sleep-disordered breathing include adenotonsillar hypertrophy, deviations in craniofacial morphology and dental occlusion. Thus, the pathogenesis of Sleep-disordered breathing (SDB) in children seems to be complex and multifactorial. 

The early detection of Sleep-disordered breathing (SDB) in children is important because there is a growing body of evidence which associates the detrimental health consequences of SDB with other health problems, such as daytime hyperactivity, attention deficit hyperactivity disorder-type manifestations and other behavioural and learning difficulties, enuresis, systemic low-grade inflammation, metabolic disturbances and compromised somatic growth and development. However, the impact of growth and development at different ages on nocturnal breathing is not fully understood.

The research study findings are based on a representative population sample of 512 girls and boys who were 6–8 years of age and lived in the city of Kuopio in Eastern Finland during baseline examinations in 2007–2009. Craniofacial morphology and dental occlusion were clinically evaluated by a standard orthodontic screening method.The parents filled out the questions regarding the child’s quantity and quality of sleep, symptoms of Sleep-disordered breathing  and upper airway infections and previous operative treatments, such as adenotonsillectomy. Sleep-disordered breathing was defined as apneas, frequent or loud snoring or nocturnal mouth breathing observed by the parents.

The results of the research study indicate that in children 6–8 years of age, tonsillar hypertrophy, cross bite and a convex facial profile, but not excess body fat, are risk factors for Sleep-disordered breathing . Interestingly, it has recently been demonstrated that deviations in craniofacial morphology are much more common in normal weight than overweight adult patients with OSAS. Together these findings imply that there may be two different phenotypes of adult Sleep-disordered breathing : one related to excess fat tissue and the other to craniofacial abnormalities. According to the observations of the present study, some of the patients with Sleep-disordered breathing due to abnormal craniofacial morphology may be identified already in childhood.Particularly in children, who are screened even less frequently than adults, Sleep-disordered breathing  is believed to be underdiagnosed. Although some studies have indicated that the risk of Sleep-disordered breathing  starts to increase only in older children, the actual age of the development of Sleep-disordered breathing remains unclear. In line with the results of previous studies, researchers found that 10 % of children 6–8 years of age had Sleep-disordered breathing although less than 1 % suffered sleep apneas.

Traditionally, adenotonsillar enlargement has been regarded as the main cause, but also overweight has been considered a risk factor for developing Sleep-disordered breathing (SDB) in children. In fact, obese children have an increased risk of persistent SDB after adenotonsillectomy. Even though in our sample overweight or obese children did not have an increased risk of Sleep-disordered breathing , the importance of excess body fat should not be underestimated because obesity is the most prevalent risk factor for Sleep-disordered breathing in adults . In children, the associations of overweight and obesity with Sleep-disordered breathing may not be straightforward, and the relationship may be modified by other factors, such as age, ethnicity and craniofacial morphology.

Related Posts with Thumbnails

Tagged with:

Filed under: Clinical ResearchDaytime SleepinessObesityObstructive Sleep ApneaSleepSleep ApneaSleep Apnea EffectsSleep Apnea in ChildrenSleep Apnea ResearchSleep Disordered BreathingSleep DisordersSleep ProblemsSnoring

Like this post? Subscribe to my RSS feed and get loads more!