Obstructive Apnea and Hypopnea Length in Normal Children and Adolescents.

Lourdes M Delrosso,Maria Paola Mogavero,Maria Samson,Greg Redding,Raffaele Ferri,Amy Fickenscher,David Panek,Nicole Sheldon,Holly Blazier,Candace Strong,Chris Ruth

doi:10.3390/brainsci11101343

Lourdes M Delrosso, Maria Paola Mogavero + Show 9 more

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https://doi.org/10.3390/brainsci11101343

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Abstract

(1) Background: Breathing is an essential function that requires both metabolic (or au-tomatic) and voluntary (behavioral) control during wakefulness but during sleep depends on metabolic control via peripheral and central chemoreceptors. Breathing during sleep disordered breathing also depends on the maturity of the neural centers and the strength of the respiratory muscles. We do not know if the response to apnea varies with age. (2) Methods: We measured the obstructive apneas and hypopneas during REM and NREM in polysomnography studies from children referred for snoring. Exclusion criteria: younger than 1 year of age, neuromuscular or syndrome comorbidity, oxygen or positive airway pressure, central apnea, and studies with loss of airflow sensors. (3) Results: Two-hundred-and-sixty-eight sleep studies were included. Mean age was 8.7 years (4.68 SD), range 1–18 years, 160 were male, and 108 were female. The 5th centile of apnea duration during NREM is above 8 s at all ages, with a tendency to increase in the oldest groups up to 10 s. During REM sleep, it shows a gradual increase from 6 s in the youngest children to 10 s in the oldest. (4) Conclusions: Apnea/hypopnea length increases with age in children and adolescents independently from sex or severity of OSA. Using adult criteria in teens seems to be accurate.

Highlights

Breathing is an essential function that requires both metabolic and behavioral control during wakefulness but depends on metabolic control during sleep
Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder characterized by repeated episodes of partial or complete upper airway obstruction during the night [5]
This obstruction usually manifests itself with a reduction or complete cessation of the air flow in the upper airways with intermittent hypoxia and an oxidative imbalance, with increased production of reactive oxygen species, tumor necrosis factors, cytokines inflammatory diseases (IL2, IL4, IL6), lipid peroxidation, and cell-free DNA [6]

Summary

Introduction

Breathing is an essential function that requires both metabolic and behavioral control during wakefulness but depends on metabolic control during sleep. Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder characterized by repeated episodes of partial or complete upper airway obstruction during the night [5]. This obstruction usually manifests itself with a reduction (hypopnea) or complete cessation (apnea) of the air flow in the upper airways with intermittent hypoxia and an oxidative imbalance, with increased production of reactive oxygen species, tumor necrosis factors, cytokines inflammatory diseases (IL2, IL4, IL6), lipid peroxidation, and cell-free DNA [6].

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