Obstructive sleep apnea is common in kids and may impact blo
Obstructive sleep apnea, a form of sleep-disordered breathing, is common in children and adolescents and may be associated with elevated blood pressure and changes in heart structure, according to a new scientific statement from the American Heart Association, published today in the Journal of the American Heart Association. A scientific statement is an expert analysis of current research and may inform future guidelines.

“The likelihood of children having disordered breathing during sleep and, in particular, obstructive sleep apnea, may be due to enlargement of the tonsils, adenoids or a child’s facial structure, however, it is important for parents to recognize that obesity also puts kids at risk for obstructive sleep apnea,” said statement writing group. “Sleep disruptions due to sleep apnea have the potential to raise blood pressure and are linked with insulin resistance and abnormal lipids, all of which may adversely impact overall cardiovascular health later in life.”

Sleep-disordered breathing is when someone experiences abnormal episodes of labored breathing, snoring and snoring sounds during sleep. It includes a spectrum of conditions from snoring to obstructive sleep apnea (OSA). OSA is associated with cardiovascular disease in adults, however, less is known about how the condition affects the immediate and long-term heart health of children and adolescents. The research reviewed for the statement reveals the following:

-- Obstructive sleep apnea disrupts normal, restorative sleep, which can impact emotional health, as well as the immune, metabolic and cardiovascular systems in children and adolescents.
-- An estimated 1-6% of all children and adolescents have obstructive sleep apnea.
-- About 30-60% of adolescents who meet the criteria for obesity (BMI more than 95th percentile) also have obstructive sleep apnea.

Risk factors for obstructive sleep apnea in children may vary with age; in general, the primary factors are obesity, upper and lower airway disease, allergic rhinitis, low muscle tone, enlarged tonsils and adenoids, craniofacial malformations and neuromuscular disorders. Sickle cell disease has also been reported as an independent risk factor for OSA. Children who were born premature (before 37 weeks gestation) may have increased risk for sleep-disordered breathing, partly due to delayed development of respiratory control and the smaller size of the upper airway. However, this risk appears to decrease as children who are born premature age and grow.

OSA may be present in children with the following symptoms:

- habitual snoring, more than 3 nights per week;
- gasps or snorting noises while sleeping;
- labored breathing during sleep;
- sleeping in a seated position or with neck hyperextended;
- daytime sleepiness;
- headache upon waking up; or
- signs of upper airway obstruction.

The statement reiterates the recommendation of the American Academy of Otolaryngology and Head and Neck Surgery that a sleep study, called polysomnography, is the best test for diagnosing sleep-disordered breathing. They recommend a sleep study before a tonsillectomy in children with sleep-disordered breathing who have conditions that increase their risk for complications during surgery, such as obesity, Down syndrome, craniofacial abnormalities (e.g., cleft palate), neuromuscular disorders (e.g., muscular dystrophy) or sickle cell disease. Children with these conditions and OSA are considered at high risk for breathing complications during any surgery. Anesthesia medicine should be carefully considered, and breathing should be closely monitored after surgery.

Source: https://newsroom.heart.org/news/obstructive-sleep-apnea-is-common-in-kids-and-may-impact-blood-pressure-heart-health