Prematurity: A Prognostic Factor for Increased Severity of Pediatric Obstructive Sleep Apnea

Jaleel, Zaroug; Schaeffer, Tyler; Trinh, Caroline; Cohen, Michael B.; Levi, Jessica R.

doi:10.1002/lary.29473

Cited by 20 publications

(19 citation statements)

References 22 publications

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“…The associated increase in clinical monitoring and oximetry before PSG could have led to an increased pretest probability for OSA among infants who may have displayed sleep‐related oxyhemoglobin desaturations or other signs of SDB during inpatient monitoring. While prematurity has been previously identified as a risk factor for OSA, this was not identified within our cohort 30,31 . This could be due to the fact that there were approximately half as many children with trisomy 21 among those with premature birth ( N = 13) compared to those who were born at term gestational age ( N = 25).…”

Section: Discussionmentioning

confidence: 67%

“…While prematurity has been previously identified as a risk factor for OSA, this was not identified within our cohort. 30,31 This could be due to the fact that there were A significant number of children were also diagnosed with CSA (N = 11, 12%). This finding may be related to the number of children with trisomy 21 in our cohort (N = 38, 43%), as an increased risk for CSA has been previously described in these children.…”

Section: Discussionmentioning

confidence: 99%

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Occurrence of sleep‐disordered breathing in children with pulmonary hypertension

Ignatiuk,

Miles,

Gurbani

et al. 2023

Pediatric Pulmonology

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BackgroundObstructive sleep apnea (OSA) has been associated with pulmonary hypertension (PH) through a complex and bidirectional relationship. The prevalence of OSA and other forms of sleep‐disordered breathing (SDB) among children with PH is not well understood. A better understanding could help elucidate contributing factors for PH, guide diagnostic testing, and inform therapies. We therefore determined the proportion of SDB codiagnosis and OSA risk factors among a cohort of children with PH.MethodsRetrospective chart review was performed for children 0−21 years old with PH who underwent polysomnography (PSG) between 1 January 2010 and 31 August 2020. The primary outcome was OSA occurrence and risk based on demographics, diagnoses, and PH classification. The secondary outcome was occurrence and risk of other SDB diagnoses based on PH classification.ResultsAmong 89 children identified, diagnoses included OSA (N = 79, 89%), central sleep apnea (N = 11, 12%), sleep‐related hypoventilation (N = 6, 7%), and non‐apneic hypoxemia (N = 28, 31%). Trisomy 21 diagnosis (N = 38, 43%) was associated with increased OSA risk (RR: 1.24, 95% CI: [1.09−1.42]) and age >12 months at PSG was associated with decreased OSA risk (N = 52, 58%, RR: 0.60, 95% CI: [0.45−0.81]). There was no difference in SDB risk based on Group 1 (N = 56, 63%) or Group 3 (N = 33, 37%) PH and no difference in OSA severity based on demographics and diagnoses.ConclusionOSA was diagnosed among a majority of children with PH, and other SDB diagnoses were identified in a significant proportion of children. These findings support routine screening for SDB with PSG in children with PH.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Occurrence of sleep‐disordered breathing in children with pulmonary hypertension

Ignatiuk,

Miles,

Gurbani

et al. 2023

Pediatric Pulmonology

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“…However, preterm delivery is a risk factor for obstructive sleep apnoea later in life. In a retrospective chart review of 615 patients, preterm neonates were at a 2.97‐fold greater risk for obstructive sleep apnoea, and more severe forms of obstructive sleep apnoea later in life than are full‐term infants 65 . However, this study did not specifically evaluate whether AOP was associated with a risk of later‐in‐life apnoea.…”

Section: Commentmentioning

confidence: 97%

The epidemiology of apnoea of prematurity

Pergolizzi

Fort

Miller

et al. 2022

Clinical Pharmacy Therapeu

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Apnoea of prematurity (AOP) does not have a precise definition, but is generally applied when a premature infant displays cessation of respiration for 20 or more seconds or less than 20 s if accompanied by cyanosis, pale colour of the skin or bradycardia (<100 beats per minute). 1 Another term that is occasionally used is apnoea and bradycardia of prematurity (ABP). We use the abbreviation AOP here for both terms. This is defined as cessation of breathing for ≥20 s accompanied by bradycardia, defined as <100 beats per minute. AOP occurs with preterm delivery, generally in an inverse relationship with gestational age (GA). Preterm birth, defined as delivery at age less than 37 weeks' gestation, is a global phenomenon with an incidence between 5% and 18% across 184 countries. 2 Approximately 15 million infants per year are born prematurely according to the World Health Organization (WHO), 3 representing a substantial

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“…Prior studies have suggested associations between prematurity and OSA. One study has shown that a history of prematurity is associated with increased AHI and diagnosis of severe OSA compared to children born at term [ 27 ]. In fact, the risk of OSA in children who are born prematurely is increased by 4–5 fold.…”

Section: Common Risk Factorsmentioning

confidence: 99%

The Association between Asthma and OSA in Children

et al. 2022

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Obstructive sleep apnea (OSA) and asthma are two of the most prevalent and commonly co-existing respiratory conditions seen in the pediatric population. Studies linking asthma and OSA in children are limited but indicate that there is a bi-directional relationship between them with significant overlap in the symptoms, risk factors, pathophysiology, comorbidities, and management. It is suggested that there is a reciprocal association between asthma predisposing to OSA, and OSA worsening symptom control and outcomes from asthma. It stands to reason that inflammation in the upper and/or lower airways can influence each other. Most of the pediatric literature that is available evaluates each aspect of this relationship independently such as risk factors, mechanisms, and treatment indications. This article highlights the relationship between OSA and asthma in the context of shared risk factors, pathophysiology, and available management recommendations in the pediatric population. Early recognition of the co-existence and association between OSA and asthma could ideally improve the treatment outcomes for these two conditions. Gaining a better understanding of the mechanism of this relationship can help identify nuances for medical management, optimize treatment and protect this population at risk from associated morbidity.

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Prematurity: A Prognostic Factor for Increased Severity of Pediatric Obstructive Sleep Apnea

Cited by 20 publications

References 22 publications

Occurrence of sleep‐disordered breathing in children with pulmonary hypertension

Occurrence of sleep‐disordered breathing in children with pulmonary hypertension

The epidemiology of apnoea of prematurity

The Association between Asthma and OSA in Children

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