Children with bigger age-adjusted neck sizes may be at increased risk for a sleep-related breathing disorder, as well as increased severity of the disease, according to a research abstract that will be presented on June 10 at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).
The study, authored by Pearl L. Yu, MD, of the University of Virginia, focused on 215 children between one-and-a-half to 18 years of age who were referred to a pediatric sleep center. Obese patients comprised 37.3 percent of this population, and had an increased frequency of snoring. Apnea-hypopnea index (AHI) and mean oxygen saturation values were used as indices of sleep-related breathing disorder severity. Neck size, measured in a sitting and neutral head position, was regressed against age, and the percent deviation was obtained from the predicted neck size for each patient.
According to the results, predicted neck size correlated with body mass index (BMI) and weight, and showed no significant correlation with height or age. In addition, predicted neck size showed a higher correlation with AHI than did BMI, weight or tonsil size. Further, predicted neck size showed a strong inverse correlation with mean oxygen saturation, and was a better predictor of mean oxygen saturation than BMI, weight or tonsil size.
"Children with bigger neck sizes for age should be queried about snoring, apnea, excessive sleepiness, and hyperactivity," said Dr. Yu. "Neck size should be considered in the clinical evaluation of children with a history of snoring and apnea."
Sleep-related breathing disorders are a group of disorders that affect our breathing while we are asleep, and are characterized by disruptions of normal breathing patterns that only occur during sleep.
The most common category of sleep-related breathing disorder is obstructive sleep apnea (OSA), which causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs.
OSA occurs in about two percent of young children. It can develop in children at any age, but it is most common in preschoolers. OSA often occurs between the ages of three and six years when the tonsils and adenoids are large compared to the throat. OSA appears to occur at the same rate in young boys and girls. How often it occurs in infants and teens is unknown. OSA also is common in children who are obese.
Symptoms of OSA tend to appear in the first few years of life. But OSA often remains undiagnosed until many years later. In early childhood OSA can slow a child's growth rate. Following treatment for OSA children tend to show gains in both height and weight. Untreated OSA also can lead to high blood pressure.
OSA is more likely to occur in a child who has a family member with OSA.
Most children with OSA have a history of snoring. It tends to be loud and may include obvious pauses in breathing and gasps for breath. Sometimes the snoring involves a continuous, partial obstruction without any obvious pauses or arousals. The child's body may move in response to the pauses in breathing. The rate of snoring in children is reported to be 10 to 12 percent.
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