Differential sleep architecture in different subtypes of positional obstructive sleep apnea in children

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-03-13 DOI:10.1016/j.ijporl.2025.112312

ChenXi Luo, Qi Li, WenBo Chen

{"title":"Differential sleep architecture in different subtypes of positional obstructive sleep apnea in children","authors":"ChenXi Luo, Qi Li, WenBo Chen","doi":"10.1016/j.ijporl.2025.112312","DOIUrl":null,"url":null,"abstract":"<div><h3>Study objectives</h3><div>This study aimed to compare the clinical characteristics of two types of positional obstructive sleep apnea (POSA) in children: supine dominant OSA (spOSA) and supine isolated OSA (siOSA). The goal was to investigate the differences in sleep structures between the two groups.</div></div><div><h3>Methods</h3><div>A total of 384 children with OSA were included. Children with POSA were categorized into two subgroups: siOSA for those with a non-supine AHI <1, and spOSA for those with a non-supine AHI ≥1. Clinical characteristics and polysomnographic features were compared between the two groups.</div></div><div><h3>Results</h3><div>Among the 384 patients with OSA, 128 (33.3 %) were classified as POSA. Weight, BMI, and BMI Z-scores were higher in the POSA group compared to the non-POSA group (NPOSA). Polysomnography (PSG) data indicated that total sleep time (TST) and N2 % were higher in the POSA group than in the NPOSA group. Minimum SaO<sub>2</sub> was lower in the POSA group, and oxygen desaturation index(ODI)values were higher compared to the NPOSA group. The rate of overweight and obesity was higher in the POSA group. Among the 128 POSA cases, 47 (36.7 %) were classified as spOSA and 81 (63.3 %) as siOSA. The siOSA patients were younger than those in the spOSA group. SiOSA patients had a higher N2 %, lower R %, and lower AHI, AHI<sub>NREM</sub>, AHI<sub>REM</sub>, OAHI, HI, and ODI compared to spOSA patients. The spOSA group had a higher rate of severe OSA compared to the siOSA group.</div></div><div><h3>Conclusion</h3><div>This study found significant differences between children with spOSA and siOSA. The spOSA group had higher values in AHI-related parameters. The spOSA group also showed a higher rate of moderate-to-severe OSA. In contrast, the siOSA group had younger age. Additionally, the siOSA group displayed abnormal sleep architecture: higher N2 % and lower R %. These differences suggest distinct pathological mechanisms may exist between the two subtypes. Therefore, targeted clinical strategies should be developed for each subtype.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112312"},"PeriodicalIF":1.2000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of pediatric otorhinolaryngology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165587625000990","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Study objectives

This study aimed to compare the clinical characteristics of two types of positional obstructive sleep apnea (POSA) in children: supine dominant OSA (spOSA) and supine isolated OSA (siOSA). The goal was to investigate the differences in sleep structures between the two groups.

Methods

A total of 384 children with OSA were included. Children with POSA were categorized into two subgroups: siOSA for those with a non-supine AHI <1, and spOSA for those with a non-supine AHI ≥1. Clinical characteristics and polysomnographic features were compared between the two groups.

Results

Among the 384 patients with OSA, 128 (33.3 %) were classified as POSA. Weight, BMI, and BMI Z-scores were higher in the POSA group compared to the non-POSA group (NPOSA). Polysomnography (PSG) data indicated that total sleep time (TST) and N2 % were higher in the POSA group than in the NPOSA group. Minimum SaO₂ was lower in the POSA group, and oxygen desaturation index(ODI)values were higher compared to the NPOSA group. The rate of overweight and obesity was higher in the POSA group. Among the 128 POSA cases, 47 (36.7 %) were classified as spOSA and 81 (63.3 %) as siOSA. The siOSA patients were younger than those in the spOSA group. SiOSA patients had a higher N2 %, lower R %, and lower AHI, AHI_NREM, AHI_REM, OAHI, HI, and ODI compared to spOSA patients. The spOSA group had a higher rate of severe OSA compared to the siOSA group.

Conclusion

This study found significant differences between children with spOSA and siOSA. The spOSA group had higher values in AHI-related parameters. The spOSA group also showed a higher rate of moderate-to-severe OSA. In contrast, the siOSA group had younger age. Additionally, the siOSA group displayed abnormal sleep architecture: higher N2 % and lower R %. These differences suggest distinct pathological mechanisms may exist between the two subtypes. Therefore, targeted clinical strategies should be developed for each subtype.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.