Obstructive sleep apnea starts from the first year of life

Obstructive sleep apnea (OSA) in very young children may cause some of the adverse cardiovascular health consequences seen in older children and adults with the condition, according to researchers in Israel, who will present their findings at the American Thoracic Society's 2008 International Conference in Toronto on Wednesday, May 21.

"OSA starts from the first year of life," said Aviv Goldbart, M.D., the pediatric pulmonologist and sleep specialist who led the study at Ben-Gurion University's Soroka Medical Center in Israel, "yet very little is known regarding the cognitive, cardiovascular and other medical consequences."

The study is the first to look at the relationship between systemic inflammation and cardiovascular morbidity in children with OSA. Researchers assessed 70 young children, ages 12 to 26 months, whose OSA was confirmed by polysomnography. The children were scheduled to undergo adenotonsillectomy (T&A) to remove enlarged tonsils and adenoids. On the morning of their surgery, the children were tested to determine levels of N Terminal pro B type Natriuretic Peptide (NTproBNP), a peptide marker of ventricular strain and C Reactive Protein (CRP), a marker for inflammation.

Compared to matched controls, 46 children with OSA had significantly higher levels of NTproBNP and of CRP. Three months after surgery, 20 children were evaluated. The average levels of NTproBNP and CRP dropped below that of the control group.

"Increased levels of CRP in children with OSA may require cardiovascular assessment," said Dr. Goldbart. "But further studies are needed first to determine the need to diagnose and treat OSA at a very young age."

He and his colleagues plan to conduct a follow-up study to determine if abnormal cardiovascular function in these children puts them at greater risk for cardiovascular morbidity as adults.