Pathological Endotypic Traits of Paediatric Obstructive Sleep Apnea: Age and Sex Differences.

IF 6.3 2区医学 Q1 RESPIRATORY SYSTEM

Respirology Pub Date : 2025-09-12 DOI:10.1111/resp.70128

Chien-Heng Lin, Liang-Wen Hang, Eysteinn Finnsson, Jón S Ágústsson, Scott A Sands, Wan-Ju Cheng

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引用次数: 0

Abstract

Background and objective: Paediatric obstructive sleep apnea (OSA) has a distinct pathophysiology and management from that of adults, yet endotypic traits in this population remain underreported. Understanding how these traits vary by age and sex could provide insights into respiratory system development. This study aims to examine the association of age and sex with endotypic traits in children and adolescents with OSA.

Methods: Between April 2020 and September 2024, we prospectively enrolled 88 patients aged ≤ 18 years who were referred to a single clinical sleep center in Taiwan for in-laboratory diagnostic polysomnography. Patients with an apnea-hypopnea index (AHI) ≥ 1 h^-1 were included. Endotypic traits were estimated using polysomnographic signals. Linear regression analysis was performed to assess the associations of endotypic traits with AHI, age, and sex.

Results: Poor compensation, worse collapsibility, and high loop gain were associated with higher AHI, with compensation explaining the largest variance (12.85%) among all endotypic traits. Patients older than 12 years exhibited a more compromised upper airway (V_min: 64.3 vs. 71.4% eupnea) and higher loop gain (LG₁: 0.45 vs. 0.34) than younger patients, independent of AHI. No significant sex differences in endotypic traits were observed.

Conclusions: In addition to upper airway collapsibility, inadequate compensatory activity of the dilator muscles significantly contributed to higher AHI in paediatric patients with OSA. The age-related decrease in upper airway patency may result from the interplay between upper airway and craniofacial development.

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儿童阻塞性睡眠呼吸暂停的病理内型特征：年龄和性别差异。

背景和目的：儿童阻塞性睡眠呼吸暂停（OSA）具有与成人不同的病理生理学和治疗方法，但这一人群的内源性特征仍未得到充分报道。了解这些特征是如何随年龄和性别而变化的，可以为呼吸系统的发育提供见解。本研究旨在探讨年龄和性别与儿童和青少年阻塞性睡眠呼吸暂停（OSA）内型特征的关系。方法：在2020年4月至2024年9月期间，我们前瞻性地招募了88名年龄≤18岁的患者，他们被转介到台湾的一个临床睡眠中心进行实验室诊断多导睡眠图检查。纳入呼吸暂停低通气指数(AHI)≥1 h-1的患者。利用多导睡眠图信号估计内源性性状。采用线性回归分析来评估内型性状与AHI、年龄和性别的关系。结果：代偿性差、溃散性差和环增益高与较高的AHI相关，代偿性解释了所有内型性状中最大的方差（12.85%）。与年轻患者相比，年龄大于12岁的患者表现出更多的上气道受损（Vmin: 64.3 vs. 71.4% eupnea）和更高的环增益（LG1: 0.45 vs. 0.34），与AHI无关。内型性状的性别差异不显著。结论：除上气道湿陷性外，舒张肌代偿活动不足是导致儿童OSA患者AHI升高的重要原因。与年龄相关的上气道通畅度下降可能是上气道和颅面发育相互作用的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respirology 医学-呼吸系统

CiteScore

10.60

自引率

5.80%

发文量

225

审稿时长

1 months

期刊介绍： Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and clinically-relevant experimental respiratory biology and disease. Fields of research include immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology, physiology, paediatric respiratory medicine, clinical trials, interventional pulmonology and thoracic surgery. The Journal aims to encourage the international exchange of results and publishes papers in the following categories: Original Articles, Editorials, Reviews, and Correspondences. Respirology is the preferred journal of the Thoracic Society of Australia and New Zealand, has been adopted as the preferred English journal of the Japanese Respiratory Society and the Taiwan Society of Pulmonary and Critical Care Medicine and is an official journal of the World Association for Bronchology and Interventional Pulmonology.