Spanish pediatricians C. Ochoa Sangrador and JM Andrés de Llano have reviewed an article that seeks to identify the health and disease status of patients before and after a diagnosis of obstructive sleep apnea syndrome (OSAS), and mortality five years after diagnosis.
The study is called “Morbidity and mortality in children with obstructive sleep apnoea: a controlled national study”, and almost 3,000 Danish patients, aged 0 to 19, have participated, in addition to 11,974 controls; It is a cohort study.
An apnea is when there are brief pauses in breathing during sleep, they do not usually have any type of consequence. But nevertheless sometimes apneas are prolonged and frequent, and can cause problems in the oxygenation of the body; of the latter, the most common type is 'obstructive apnea', whose cause is airway obstructions (due to hypertrophy of tonsils or adenoids - vegetations -) It is a problem that occurs with some frequency (between the one and the three percent of healthy children of preschool age);
and the incidence is higher in overweight children, obesity, skull or face abnormalities, diseases of the nervous system or throat - nose - ear
Perhaps many have gone through this: The treatment involves removing tonsils and vegetations, thus improving the opening of the airway; It is also possible to help the child breathe while sleeping, by administering air with nasal masks.
But before arriving there we will have gone to the pediatrician with suspicion because the child was snoring intensely, and the snoring was followed by respiratory pauses or restless breathing, restless sleep, unusual postures, tiredness / numbness during the day, or behavioral problems.
About the study
Through data taken from the Danish National Patient Registry (RNPD), have compared children with a diagnosis of OSA, with others who did not have it. The former had a higher frequency of different diseases before and after diagnosis.
It speaks of respiratory diseases, nervous system, digestive, infections, even cancer. And it was observed that in the years after diagnosis these children had higher mortality (five to 6.58 times higher).
Of course, the study has its limitations because it is not clear that the children whose data have been analyzed represent the whole with SAOS, since it is likely that in the database used is a selection of the most serious. It is not known if the percentage of mortalities is only attributable to the existence of apneas, or if these patients can be improved with the available treatments.
After the review, it is concluded that it is necessary to know more accurately what proportion of the risk is attributable to SAOS, and if it is avoidable with respiratory support measures or interventions on the disease.
I have to comment that I have talked about the suspicions that would make us think of obstructive apnea, and it goes without saying that to confirm them, in the hospital they can perform a surveillance test of breathing, circulation and activity during sleep.
