Central apneas in children with obstructive sleep apnea syndrome: prevalence and effect of upper airway surgery.

BACKGROUND

The aim of this study is to investigate the prevalence of central sleep apneas syndrome (CSAS) in children with obstructive sleep apnea syndrome (OSAS) and the effect of adenotonsillectomy (A)TE on CSAS.

METHODS

Retrospective analysis of polysomnographic data in children diagnosed with OSAS and without comorbidity. A central apnea index (CAI) ≥1/h is considered abnormal and central sleep apnea syndrome (CSAS) is diagnosed at a CAI >5/h. Data are presented as median (25-75 percentile).

RESULTS

Data were available for 90 children, 35 girls and 55 boys, age 3.7 years (1.8-5.4), BMI-z score 0.20 (-0.85-0.90), oAHI 10.9/h (5.8-19.1). Sixty-four percent had an abnormal CAI and the prevalence of CSAS was 7.8%. There was a significant correlation between CAI and MinSat (r = -0.48, p = 0.01) and between CAI and age (r = -0.45, p = 0.01). Pre-postop PSG data were available for 41 children with a CAI ≥ 1/h. Central apnea index decreased from 2.2/h (1.7-3.8) to 1.3/h (0.8-2.6) (p < 0.001) following (A)TE along with an improvement in oAHI from 10.9/h (5.9-22.2) to 1.2/h (0.6-2.7) (p < 0.001). No patient had postoperative CSAS and a reduction in the CAI <1/h was observed in 11 patients (26,9%).

CONCLUSION

A central apnea index ≥1/h is common in children with OSAS but CSAS (CAI >5) is rare. We observed a significant decrease in the CAI and a resolution of CSAS after (adeno)tonsillectomy.