Pediatric obstructive sleep apnea: a potential late consequence of respiratory syncitial virus bronchiolitis.
OBJECTIVE
To examine the hypothesis that children who suffered from severe respiratory syncitial virus (RSV) bronchiolitis during infancy may be at higher risk for obstructive sleep apnea (OSA) later in childhood.


METHODS
Survey of Kosair Children's Hospital medical records allowed for identification of potential candidates for the study. Twenty-one randomly selected children (mean age +/- SD: 5.2 +/- 1.5 years) with a history of verified RSV-induced bronchiolitis during their first year of life underwent overnight sleep study (NPSG). Children recruited from the general population with no history of RSV bronchiolitis served as a control group. After matching for age, gender, ethnicity, gestational age at birth, body mass index (BMI) z scores, household cigarette smoking, history of asthma and allergies, 63 control subjects (mean age +/- SD: 5.1 +/- 0.7 years) were also studied.


RESULTS
Children who had RSV bronchiolitis as infants had significantly higher obstructive apnea/hypopnea index compared to controls (2.3 +/- 1.9 vs. 0.6 +/- 0.8 /hr total sleep time (TST); P < 0.05). In addition, significantly higher respiratory arousal indices were apparent among children with previous RSV bronchiolitis compared to controls (1.3 +/- 1.0 vs. 0.1 +/- 0.2 /hr TST; P < 0.05). There were no significant differences between the groups in the lowest SpO(2), ETCO(2), and sleep indices.


CONCLUSIONS
RSV bronchiolitis may contribute to the pathophysiology of OSA in vulnerable children.
Snow
Ayelet
A
Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, and Kosair Children's Hospital Research Institute, Louisville, Kentucky 40202, USA.
Dayyat
Ehab
E
Montgomery-Downs
Hawley E
HE
Kheirandish-Gozal
Leila
L
Gozal
David
D
D001990:Bronchiolitis, Viral / Q000150:complications*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000150:complications*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000821:virology*