Abstract
Background
Asthma and obstructive sleep apnea (OSA) in children share multiple epidemiological risk factors and the prevalence of snoring is higher in asthmatic children, suggesting that the latter may be at increased risk for OSA. Since both asthma and OSA are inflammatory disorders, we hypothesized that polysomnographically demonstrated OSA would be more frequent among poorly controlled asthmatics (PCA), and that treatment of OSA, if present, would ameliorate the frequency of acute asthmatic exacerbations (AAE).
Methods
Children with PCA were referred for an overnight sleep study, and adenotonsillectomy (tonsillectomy and adenoidectomy, T&A) was performed if OSA was present. Frequency of asthma symptoms and exacerbations were compared.
Results
Ninetyβtwo PCA children, ages 3β10 years, with a mean frequency of AAE of 3.4βΒ±β0.4/year were prospectively referred for a sleep study. OSA (i.e., AHIβ>β5/hrTST) was present in 58 patients (63.0%; OR: 40.9, 12.9β144.1, Pβ<β0.000001 compared to the prevalence of OSA in a nonβasthmatic population). Information at 1βyear followβup was available for 35 PCA children after T&A. The annual frequency of AAE, rescue inhaled use, and asthma symptoms in this subβgroup decreased compared to no changes in the group without OSA.
Conclusions
The prevalence of OSA is markedly increased among PCA children and treatment of OSA appears to be associated with substantial improvements in the severity of the underlying asthmatic condition. Pediatr. Pulmonol. 2011; 46:913β918. Β© 2011 WileyβLiss, Inc.