« Cesarean May Not Save Premature Babies | Home | No Positive Cardiac Benefits from Vitamin D for Kidney Disease »

Sleep Apnea Treatment May Improve Children’s Behavior

By jeremyc | February 14, 2012

Researchers have found that using positive airway pressure or PAP to treat obstructive sleep apnea in teenagers and children can improve their neurobehavioral outcomes even if the apnea treatment is not that successful. After three months of the study conducted by the Children’s Hospital of Philadelphia, PAP was associated with the occurrence of ADHD symptoms, sleepiness, quality of life and behavior.

Dr. Carole Marcus, MBBCh and principle researcher in this study, said that the benefits were also seen in children with developmental disability and those younger than 7 years of age. The study was published in the American Journal of Respiratory and Critical Care Medicine. In this published report, Dr. Marcus says, “These improvements occurred despite a mean use of only three hours per night.” The report further states that even though the PAP is used less than usual, the improvements were still observed. The time required for such improvements to peak is not known, but it may be more than three months. The published report suggested that further long-term studies be conducted as a follow-up to this study.

Sleep apnea is known to affect 4% of all children in the U.S., and is associated with neurobehavioral disturbances. In most cases, the syndrome is associated with adenotonsillar hypertrophy. Sleep apnea can be treated to an extent with an adenotonsillectomy, but some children may require PAP therapy.

The study was conducted by Dr. Marcus and other researchers by performing a randomized trial on pediatric sleep apnea patients that compared two PAP deliveries- bilevel pressure releases or Bi-Flex, and continuous PAP or CPAP.

The two types of PAP deliveries have similar efficacy, so the patients were combined for analysis. There were a total of 52 pre-adolescent children and teenagers participating in the study, and their mean age was 12. The application of PAP therapy varied broadly, but the average use was 170 minutes per night for three months. The PAP improved sleep parameters and respiratory parameters, which were measured using polysomnography. Despite a low rate of application of PAP therapy, it resulted in improvements in almost every neurobehavioral domain measured at the beginning of the study and after three months. These domains included Epworth Sleepiness Scale, ADHD symptoms, internalizing behavior symptoms and overall behavior. The quality of life reported by caregivers and patients also improved over the course of the study.

Patients whose neurobehavioral domain scores were abnormal saw a significant reduction toward normal levels over the course of 3 months of PAP therapy. The improvements were in relation to the adherence for the Epworth Sleepiness Scale, and not for other outcomes. This lack of correlation between other neurobehavioral outcomes and PAP therapy in the current study may have surfaced due to differences in physiologic sleep requirements over the age group.

In other words, the effects of CPAP therapy for 4 hours at night may not be as beneficial for a 2-year child who sleeps 12 hours a night, as for a 16-year child who sleeps 8 hours a night. These limitations, as well others, such as the lack of placebo groups and the inability to conduct a blind trial, were acknowledged.

Topics: | Uncategorized |

Comments are closed.