Sleep apnea is a breathing disorder characterized by pauses in breathing during sleep. These short stops in breathing usually lasts for 10 to 30 seconds and can happen up to 400 times every night. Men, people who are overweight or over the age of 40 are more likely to have sleep apnea, but it can affect anyone at any age, even children. Obstructive sleep apnea (OSA), a common type of apnea in children, is caused by an obstruction of the airway, such as enlarged tonsils and adenoids. This is most likely to happen during sleep because that’s when the soft tissue at the back of throat is most relaxed. Children who have OSA nearly always snore, may have difficulty breathing during sleep, and may be restless during sleep and wake up often. Symptoms of OSA tend to appear in the first few years of life, but the disorder often remains undiagnosed until many years later.
Once a doctor completes an evaluation and makes a diagnosis, most cases of OSA can be treated or managed with surgery, medications and monitoring devices. Generally, a polysomnagram or overnight sleep study is used to confirm obstructive sleep apnea. It charts the child’s brain waves, heartbeat, and breathing during sleep. It also records arm and leg movements. The study requires the child and a parent or guardian to spend the night at the sleep center. In some cases other tests, including endoscopy and magnetic resonance imaging, may be used to evaluate the child’s upper airway. But a recent discovery may lead to a much simpler way to detect whether a children has OSA—a simple urine test.
Dr. David Gozal, a professor and chairman of pediatrics at the University of Chicago, and colleagues studied 90 children who had been referred to a sleep clinic for evaluation of breathing problems during sleep and 30 non-snoring children. All the children underwent standard overnight sleep tests and were categorized either as having OSA, habitual snoring or no sleep disordered breathing. The morning after the tests, urine samples were collected and screening using a sophisticated electrophoresis technique. The researchers found that the expression of a number of proteins in children with OSA was different than in those who didn’t snore or who snored habitually. “It was rather unexpected that the urine would provide us with the ability to identify OSA,” Gozal said. “However, the field of biomarkers is one that is under marked expansion, and this certainly opens the way for possible simple diagnostic screening methods in the future.”
“We wish to validate these findings in urine samples from many children from laboratories around the country and to develop a simple, color-based test that can be done in the physician office or by the parents” Gozal said, pointing out that such a test “would alleviate the need for costly and inconvenient sleep studies in children who snore, only about 20 to 30 percent of whom actually have OSA.”
OSA affects 1 to 10 percent of children. In early childhood, OSA can slow a child’s growth rate. Cognitive and behavioral problems such as aggressive behavior and poor school performance are common in children with OSA. Untreated, OSA can also lead to high blood pressure and cardiopulmonary disease.
by Madeline Ellis/healthnews.com
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