Children aged three and younger who have a sleeping disorder known as sleep apnea show more respiratory disturbance when they sleep on their backs, according to a study in the November issue of Archives of Otolaryngology - Head & Neck Surgery.
Obstructive sleep apnea syndrome (OSAS) is a serious medical problem affecting an estimated half a million children per year in the United States, according to background information in the article. Pediatric OSAS is most 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 quality of sleep. Symptoms during the day can include mouth breathing, behavior problems, hyperactivity, and excessive daytime sleepiness. While research among adults has shown a significant decrease in OSAS episodes when patients avoid sleeping on their backs (the supine position), the issue of sleep position is not as well understood among children with OSAS.
Kevin D. Pereira, M.D., and colleagues at the University of Texas Health Science Center at Houston conducted a retrospective chart review to evaluate the association between body position and OSAS events during sleep in children aged three and younger. The study included 60 children who underwent polysomnography (PSG, the continuous recording of physiologic variables during sleep) to evaluate OSAS, and later had surgery to remove their tonsils and adenoid tissue, between December 1, 2000, and November 30, 2003. The PSGs were analyzed for data on the respiratory disturbance index (RDI, an index measuring respiratory events that disturb sleep), time spent in each body position during sleep, the number of apneic events in each position, oxygen saturation, and time spent in each stage of sleep.