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Link Found Between Sleep Apnea,
Body Position in Children
Obstructive sleep apnea syndrome is a serious medical problem
affecting 500,000 children every year in the United States
Researchers at The University of Texas Medical School at Houston have discovered that toddlers with sleep apnea experience more respiratory disturbances when they sleep on their backs than in other positions.
Kevin D. Pereira, M.D.
Their findings, which contradict earlier studies on the subject, were published in the November issue of Archives of Otolaryngology – Head & Neck Surgery.
Obstructive sleep apnea syndrome (OSAS) is a serious mssedical problem affecting 500,000 children every year in the United States. Pediatric OSAS is commonly caused by enlarged tonsils and adenoids. It is characterized by episodes of partial or complete upper airway obstruction that occur during sleep, including snoring, cyanosis (a bluish color of the skin and mucous membranes), and poor sleep quality. Daytime symptoms can include mouth breathing, behavior problems, hyperactivity and excessive daytime sleepiness.
Kevin D. Pereira, M.D., professor of otolaryngology at the UT Medical School and chief pediatric otolaryngologist at Memorial Hermann Children’s Hospital, evaluated the association between body position and OSAS events during sleep in toddlers up to age 3. Results came from sleep studies of 60 children at the hospital between December 2001 and December 2003.
The children underwent continuous recording of physiologic variables during sleep to evaluate OSAS, and later had their tonsils and adenoid tissue removed. Data were analyzed for the respiratory disturbance index (RDI, an index measuring respiratory events that disturb sleep), time spent in each body position during sleep, the number of apnea events in each position, oxygen saturation, and time spent in each stage of sleep.
“The mean RDI rose when more than 50 percent of the time was spent in supine (face upwards) sleep,” Pereira said. “There was even more of an increase when supine sleep accounted for 75 percent of the total sleep time. In fact, the RDI in this position was greater than in all other positions combined.”
Pereira, who was lead author, noted that the study was not conducted on infants, so this study’s findings shouldn’t be confused with the practice of having infants sleep on their sides or back to help avoid Sudden Infant Death Syndrome.
Co-authors were Jeremy Roebuck, M.D., chief resident in otolaryngology/head and neck surgery, and Lori Howell, M.D., a UT Medical School alumna, who is now an otolaryngology resident at Northwestern University in Chicago.
By Shannon Rasp, Public Affairs