Magnusdottir S, Hilmisson H, Raymann R, Witmans M. Characteristics of Children Likely to Have Spontaneous Resolution of Obstructive Sleep Apnea: Results from the Childhood Adenotonsillectomy Trial (CHAT). Children 2021; 8: 980. DOI: 10.3390/children8110980
Appropriate sleep duration and good sleep quality are important for healthy growth and development of children. Sleep disordered breathing (SDB), characterized by abnormal respiratory and ventilation patterns during sleep, is a prevalent condition in children with disease severity ranging from primary habitual snoring (prevalence of 6–25%) to complete obstruction of the airway (estimated prevalence 3–6%). The most common risk factors for OSA in children are enlarged tonsils and/or adenoids and obesity, but upper and lower airway disease, allergic rhinitis, low muscle tone and certain cranial structures such as midface deficiency and mandibular hypoplasia that may affect the size of the upper airway may also cause OSA. The most common treatment for OSA in children is adenotonsillectomy.
The aim of this study was to evaluate if cardiopulmonary coupling (CPC) calculated sleep quality (SQI) may have a role in identifying children that may benefit from other amicable interventions, such as watchful waiting, intranasal steroids or montelukast, rather than early adenotonsillectomy (eAT) in management of obstructive sleep apnea (OSA).
Spontaneous resolution of OSA is more likely in children with high CPC-SQI and mild-OSA and may therefor benefit from initial treatment intervention based of watchful waiting rather than surgery.
As healthy weight children with high-SQI and mild OSA may improve without surgery, it may be appropriate to start with less invasive therapies and repeated sleep testing to observe how their OSA develops.