AHA Releases New Guidance on Obstructive Sleep Apnea in Children

The American Heart Association has released a new scientific statement on the diagnosis and management of obstructive sleep apnea (OSA) in children and adolescents.

Despite being a major risk factor for cardiovascular disease (CVD), OSA is not often considered in pediatric populations. OSA may increase the risk of hypertension, abnormal blood pressure regulation, metabolic syndrome, arrhythmia, abnormal ventricular morphology, impaired ventricular contractility, and elevated right heart pressure.

To diagnose OSA and other sleep-disordered breathing, a polysomnography is recommended. A sleep study should be conducted before a tonsillectomy in children who have an increased risk of complications, including those with obesity, Down syndrome, and sickle cell disease. These recommendations follow that of the American Academy of Otolaryngology and Head and Neck Surgery.

Obesity, upper and lower airway disease, allergic rhinitis, low muscle tone, enlarged tonsils and adenoids, craniofacial malformations, neuromuscular disorders, sickle cell disease, and premature birth are among the risk factors for OSA, which vary with age.

“To better understand the long-term CVD-related risk associated with the presence of OSA in childhood, additional well-designed longitudinal studies incorporating ambulatory blood pressure monitoring data and measures of metabolic disease (eg lipid profile, glucose, and glycated hemoglobin levels) are needed over time,” the researchers concluded. “Also important are studies evaluating the relationship between OSA and noninvasive markers of CVD, including carotid intima media thickness and pulse wave velocity.”

—Leigh Precopio

Reference:

Baker-Smith CM, Isaiah A, Melendres MC, et al. Sleep-disordered breathing and cardiovascular disease in children and adolescents: a scientific statement from the American Heart Association. J Am Heart Assoc. Published online August 18, 2021. https://doi.org/10.1161/JAHA.121.022427