Research into childhood obstructive sleep-disordered breathing examined

August 03, 2017

GLENVIEW, IL, August 3, 2017 - Although sleep apnea is typically considered a condition affecting adults, breathing problems during sleep in children are common and may affect their health and behavior. Disturbed sleep in children due to breathing problems is often caused by large tonsils and adenoids blocking the upper airways. This is called obstructive sleep-disordered breathing (oSDB) and has been the subject of increased research during the past decade. While milder forms of oSDB are most common, the more severe form requires tonsil or adenoid surgery. Through a comprehensive review of published research, investigators have identified important gaps in how and where children with this condition are best managed. Their findings are published in the journal CHEST.

Breathing problems during sleep vary from simple snoring without impact on sleep or oxygen saturation in the blood, to obstructive sleep apnea (OSA), during which children have repeated episodes of restricted breathing and/or drops in oxygen saturation levels. Although clinical guidelines for treatment were issued by the American Academy of Pediatrics (AAP) in 2012, there is still debate on the best pathway of care for children.

According to lead investigator Anne G. M. Schilder, PhD, evidENT, Ear institute, University College London, Royal National Throat Nose and Ear Hospital, "oSDB is a very common condition in children and reports suggest its incidence is on the rise. This may be in part related to the increase in childhood obesity. Parents and professionals have become more aware that this condition may have negative long-term health consequences and, therefore, it is important that children suffering from this condition are well managed and available resources are allocated appropriately. This means timely treatment of children who need it and avoiding unnecessary surgery of those unlikely to benefit from it."

Based on the patient's symptoms and signs alone, it is difficult for doctors in primary care and hospitals to distinguish the more common milder forms of oSDB from the more severe. "A sleep study is the gold standard but expensive and not widely available," explained Prof Schilder. "There is no agreement regarding which patients need such a study and how best to interpret its results, that is who needs surgery or medical treatment. Rather than focusing research on individual steps in the patient pathway, there is a need for a more holistic approach to research in this area, taking into account the views of all professionals caring for these children, as well as their parents."

Therefore, investigators carried out a systematic review to map the research in childhood oSDB that has been conducted to date. Their goals were to support further guideline development, identify evidence gaps, and guide future research. Evaluating more than 5,700 studies through November 2015 eligible for inclusion, they identified an increase in annual publications since 2000, with 46% published since 2011, when evidence-based data for the AAP guidelines were evaluated.

Most publications (61%) focused on individual treatment modalities, incidence, or prognosis. Few publications (2.7%) focused on health service delivery, outcomes, and health economics. Observational studies comprised 78.5% of publications, 2.4% were randomized controlled trials, and 0.4% used a qualitative approach as their main methodology.

Investigators found that the recent surge in research activity into childhood oSDB has improved the knowledge base for this condition; however, the lack of health services, health economics, and outcomes research impacts the applicability of evidence informing current guidance and leaves important questions for future research.

"Mapping so many papers has been quite an undertaking for our team, but so rewarding, since it highlights clearly what future research should focus upon," concluded Prof Schilder.
-end-


Elsevier

Related Sleep Apnea Articles from Brightsurf:

Sleep apnea may be risk factor for COVID-19
The question of sleep apnea as the risk factor for COVID-19 arose in a study conducted by the Turku University Hospital and the University of Turku on patients of the first wave of the pandemic.

Untreated sleep apnea is associated with flu hospitalization
As we approach flu season, adults with obstructive sleep apnea may want to take extra precautions.

Losing tongue fat improves sleep apnea
Using magnetic resonance imaging (MRI) to measure the effect of weight loss on the upper airway in obese patients, researchers found that reducing tongue fat is a primary factor in lessening the severity of OSA.

More cancer cases among women with sleep apnea
Women with severe sleep apnea appear to be at an elevated risk of getting cancer, a study shows.

New evidence on the association of shortened sleep time and obstructive sleep apnea with sleepiness and cardiometabolic risk factors
A new study in the journal CHEST® may change the way we think about sleep disorders.

Synthetic cannabis-like drug reduces sleep apnea
A synthetic cannabis-like drug in a pill reduced apnea and daytime sleepiness in the first large multi-site study of a drug for apnea.

Inflammation may precede sleep apnea, could be treatment target
Inflammation is traditionally thought of as a symptom of sleep apnea, but it might actually precede the disorder, potentially opening the door for new ways to treat and predict sleep apnea, according to researchers.

Concerns that sleep apnea could impact healthspan
The number of people with obstructive sleep apnea has steadily increased over the past two decades.

Sleep apnea and insomnia combination linked with depression
A new study found that men with sleep apnea and insomnia have a higher prevalence and severity of depressive symptoms than men with sleep apnea or insomnia alone.

Anti-nausea drug could help treat sleep apnea
An old pharmaceutical product may be a new treatment for obstructive sleep apnea, according to new research presented today by University of Illinois at Chicago and Northwestern University scientists at the SLEEP 2017 annual meeting in Boston.

Read More: Sleep Apnea News and Sleep Apnea Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.