[Absence of positional effect in children with moderate-severe obstructive sleep apnea syndrome].
BACKGROUND
Sleep apnea syndrome (SAS] is common in both adults and children (amongst whom it is estimated at 2-3%). This syndrome significantly affects the child's daily activities and development. Research in adults has demonstrated a direct relationship between sleeping supine and the severity of sleep apnea syndrome. Very few studies were conducted among children and the findings were controversial.


OBJECTIVE
The goal of this study was to continue examining and establishing the relationship between children's sleep position and the severity of sleep apnea syndrome.


METHODS
The study group consisted of 25 children with cLinically suspected obstructive sleep apnea [OSA), referred to the Technion's Sleep Lab for confirmation of this diagnosis. The study course included nocturnal recording of the children and closely monitoring their sleep position. Data analysis included a comparison of the various data regarding the severity of the children's respiratory disturbance, at each stage of sleep and in each sleeping position separately. Analysis of the results was performed using the paired T test.


RESULTS
Sixteen boys and 9 girls aged 5.5 years (range 2-12 years) with various severity of OSA, most of them with moderate-severe degree of sleep apnea, [average respiratory disturbance index of 14.7 +/- 12.3/h) were studied. In most children the recording consisted of all sleep postures, but no statistically significant relationship was found between the various sleeping positions and the severity of OSA, neither in REM sleep nor in NREM sleep.


CONCLUSIONS
We believe that the absence of positional effect in children with moderate-severe obstructive sleep apnea syndrome results from a different mechanism and site of obstruction. While in adults the Location of obstruction is mostly retroglossal or retropalatal, in children it is usually at the levels of tonsils and adenoids.
Mitki
Tali
T
The Family Medicine Department, Emek Medical Center, North District. mitki_oo@yahoo.com
Pillar
Giora
G
D000234:Adenoids / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D014066:Palatine Tonsil / Q000503:physiopathology; D011187:Posture / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000628:therapy; D016683:Supine Position / Q000502:physiology*