Sleep apnea in toddlers hard on the heart

By Megan Rauscher

NEW YORK (Reuters Health) - Obstructive sleep apnea (OSA) in children younger than 3 years of age may strain the heart and cause inflammation, according to research discussed today at the American Thoracic Society's annual meeting in Toronto.

OSA is a disorder in which the airway repeatedly becomes blocked during sleep resulting in a temporary halt in breathing. Classical symptoms in children include snoring, abnormal breathing or lots of movements during sleep. It's estimated that approximately 1 percent to 3 percent of children have OSA. Removal of the adenoids and tonsils, a procedure called adenotonsillectomy, is often used to treat OSA in children.

The current study shows "for the first time" that OSA in very young children may cause some of the cardiovascular health consequences seen in older children and adults with the condition, Dr. Aviv Goldbart from Soroka Medical Center, Ben Gurion University, Beer Sheba, Israel, told Reuters Health.

The children, who ranged in age from 12 to 26 months, were having adenotonsillectomy to remove enlarged tonsils and adenoids.

Before surgery, Goldbart and colleagues observed significantly higher levels of a peptide marker of heart strain called NTproBNP in 46 children with OSA compared with levels seen in 22 control children who did not suffer from sleep apnea.

They also observed significantly higher blood levels of the inflammatory marker C-reactive protein, or CRP, in children with OSA compared to control children.

Moreover, the severity of OSA-induced hypoxia (low oxygen) during the night correlated significantly with abnormal heart function.

In 20 children who were evaluated 3 months after adenotonsillectomy, average NTproBNP and CRP levels had fallen to below that of control children.

"We showed that adenotonsillectomy -- the chosen treatment for children with sleep apnea -- causes a significant decrease in inflammation and the strain of the heart," Goldbart said.

Increased CRP levels in children with OSA may require cardiovascular assessment, Goldbart added, "but further studies are needed to first determine the need to diagnose and treat OSA at a very young age."

Goldbart's team plans to conduct a follow up study to see if abnormal heart function in young children with OSA puts them at greater risk for heart-related ailments as adults.