Obstructive sleep apnoea in most children with pulmonary hypertension

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

Dr Daniel Ignatiuk (Cincinnati Children’s Hospital, OH, USA) presented a 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]. Identified were 403 patients aged 0–21 years 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%). Group 2 consisted of only 2 patients and was 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 in 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 was 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 Dr 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 July, 202220 February, 2024