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Clinical and Functional Characteristics of OSA in Children with Comorbid Asthma Treated by Leukotriene Receptor Antagonist: A Descriptive Study

Overview
Journal Front Neurol
Specialty Neurology
Date 2023 Jan 23
PMID 36686503
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Abstract

Background: Obstructive sleep apnea (OSA) is the most common form of respiratory disorders during sleep in children, especially those with severe asthma. However, optimal treatment of asthma might significantly improve OSA severity.

Methods: It was a cohort study including children aged >5 years old and diagnosed with asthma according to GINA (Global Initiative for Asthma). The data related to age, gender, height, weight, body mass index (BMI), clinical symptoms and medical history of asthma, spirometry (FEV: forced expiratory in 1 s), and exhaled nitric oxide (FNO) were recorded for analysis. Respiratory polygraphy (RPG) was done for each study subject to diagnose OSA and its severity.

Results: Among 139 asthmatic children, 99 patients with OSA (71.2%) were included in the present study (9.3 ± 0.2 years): 58.6% with uncontrolled asthma and 32.3% with partial controlled asthma. The mean ACT (asthma control testing) score was 19.0 ± 3.4. The most frequent night-time symptoms were restless sleep (76.8%), snoring (61.6%), sweating (52.5%), and trouble breathing during sleep (48.5%). The common daytime symptoms were irritable status (46.5%) and abnormal behavior (30.3%). The mean AHI (apnea-hypopnea index) was 3.5 ± 4.0 events/h. There was a significant correlation between BMI and snoring index ( = 0.189 and = 0.027), bronchial and nasal FNO with AHI ( = 0.046 and < 0.001; = 0.037 and < 0.001; respectively). There was no significant correlation between asthma level, FEV and AHI. The severity of asthma and respiratory function were improved significantly after 3 months and 6 months of asthma treatment in combination with leukotriene receptor antagonist (LRA) treatment. The symptoms related to OSA were significantly improved after treatment with LRA. The severity of OSA was decreased significantly after 3 months and 6 months of treatment.

Conclusion: The treatment of asthmatic children with comorbid OSA by LRA in combination with standard therapy for asthma could improve the control of asthma and the symptoms and severity of OSA.

References
1.
Sanchez T, Castro-Rodriguez J, Brockmann P . Sleep-disordered breathing in children with asthma: a systematic review on the impact of treatment. J Asthma Allergy. 2016; 9:83-91. PMC: 4844256. DOI: 10.2147/JAA.S85624. View

2.
Larsson L, Lindberg A, Franklin K, Lundback B . Symptoms related to obstructive sleep apnoea are common in subjects with asthma, chronic bronchitis and rhinitis in a general population. Respir Med. 2001; 95(5):423-9. DOI: 10.1053/rmed.2001.1054. View

3.
Tran-Minh D, Phi-Thi-Quynh A, Nguyen-Dinh P, Duong-Quy S . Efficacy of obstructive sleep apnea treatment by antileukotriene receptor and surgery therapy in children with adenotonsillar hypertrophy: A descriptive and cohort study. Front Neurol. 2022; 13:1008310. PMC: 9552176. DOI: 10.3389/fneur.2022.1008310. View

4.
Franklin K, Lindberg E . Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis. 2015; 7(8):1311-22. PMC: 4561280. DOI: 10.3978/j.issn.2072-1439.2015.06.11. View

5.
Julien J, Martin J, Ernst P, Olivenstein R, Hamid Q, Lemiere C . Prevalence of obstructive sleep apnea-hypopnea in severe versus moderate asthma. J Allergy Clin Immunol. 2009; 124(2):371-6. DOI: 10.1016/j.jaci.2009.05.016. View