Age specific differences in pediatric obstructive sleep apnea

Central sleep apnea in children with obstructive sleep apnea syndrome and improvement following adenotonsillectomy

“…Nearly a decade ago, Don et al reported the surprising incidence of central apneas in children with OSAS. 10 Other authors 7 later reported similar findings, as well as an improvement in the number of central apneas after adenotonsillectomy performed for OSAS, 11,12 not only in healthy children but also in the population with Down syndrome. 7 The pathogenesis of central and obstructive events seems to be different, as CSA is believed to involve dysfunction of ventilatory control in the central nervous system, while OSAS has been linked to anatomic obstruction and increased upper airway resistance 1 ;…”

“…Central and obstructive apneas may share a common pathophysiology. Nearly a decade ago, Don et al reported the surprising incidence of central apneas in children with OSAS . Other authors later reported similar findings, as well as an improvement in the number of central apneas after adenotonsillectomy performed for OSAS, not only in healthy children but also in the population with Down syndrome …”

“…8 There is also evidence of central events in patients with upper airway obstruction caused by laryngomalacia 9 and in obstructive sleep apnea-hypopnea syndrome (OSAS). 10 Both obstructive and central indices improve after adenotonsillectomy. 1,7,11,12 The aim of this study was to determine whether the number of central sleep apnea (CSA) cases in our population of children with OSAS is greater than in those without obstructive events, and if central apnea worsens with increasing severity of OSAS.…”

“…CSA presents more frequently in patients with certain diseases, including syndromes such as Prader‐Willi or Down syndrome and diseases causing compression of the central nervous system (eg, Chiari malformation) . There is also evidence of central events in patients with upper airway obstruction caused by laryngomalacia and in obstructive sleep apnea‐hypopnea syndrome (OSAS) . Both obstructive and central indices improve after adenotonsillectomy …”

A pilot study to identify pre- and peri-operative risk factors for airway complications following adenotonsillectomy for treatment of severe pediatric OSA

“…The comorbidities of young age and obesity are often tightly intertwined with OSA, making it difficult to parse out disease severity as an independently predictive factor of post-operative complications. The proportion of children with moderate and severe OSA is greater in those aged 1-2 years when compared to older children up to age 18 [26]. Obesity is increasingly common with approximately 10% of US children aged 2-5 and nearly 20% of children aged 6-11 at or above the 95th percentile for BMI in 2007 and 2008 [27].…”