Obstructive sleep apnoea in most kids with PH

New data from paediatric patients with pulmonary hypertension (PH) found that a majority is affected by obstructive sleep apnoea (OSA), prompting investigators to suggest routine screening for OSA in this population.

Prof. Daniel Ignatiuk (Cincinnati Children’s Hospital, OH, USA) presented the retrospective study analysing OSA risk factors documented in a 10-year cohort of paediatric patients with PH at the Cincinnati Children’s Hospital, between January 2010 and August 2020 [1]. A total of 403 patients aged 0-21 years were identified who underwent diagnostic polysomnogram (PSG), including 89 patients with a documented diagnosis of PH (median age 3.6 years, range 9 days to 17.6 years). These 89 patients were sub-classified based on their PH group: group 1 (n=25, 28.1%), group 3 (n=31, 34.8%), and group 1/3 for patients meeting both group 1 and 3 criteria (n=33, 37.1%). There were only 2 patients in group 2, which were excluded from the analysis due to the low number.

Diagnosed sleep disorders included OSA (n=79, 88.8%), central sleep apnoea (n=11, 12.4%), hypoventilation (n=6, 6.7%), non-apnoeic hypoxaemia (n=28, 31.5%), and periodic limb movement disorder (n=5, 5.6%). OSA risk was increased with a diagnosis of trisomy 21 (RR 1.24; 95% CI 1.09–1.42; P<0.05).

However, OSA risk was decreased with group 1 compared with group 1/3 PH (RR 0.84; 95% CI 0.71–0.99; P<0.05) or group 3 PH (RR 0.81; 95% CI 0.68–0.96; P<0.05), and no difference in OSA risk between group 1 and group 3 PH was observed.

The take-home message for this study is that OSA was diagnosed in a majority of paediatric patients, most notably in patients with trisomy 21 or PH classification meeting both group 1 and 3 criteria. “Our research supports routine screening for OSA in this population, especially,” concluded Prof. Ignatiuk.

1. Ignatiuk D, et al. Risk for Obstructive Sleep Apnea in Pediatric Patients with Pulmonary Hypertension Session A68, ATS International Conference 2022, San Francisco, CA, USA, 13–18 May.

 

 

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Posted on 18 May, 2022