Adipositas - Ursachen, Folgeerkrankungen, Therapie 2008; 02(04): 187-190
DOI: 10.1055/s-0037-1618646
Adipositas und Lunge
Schattauer GmbH

Obstruktives Schlafapnoesyndrom bei adipösen Kindern und Jugendlichen

Obstructive sleep apnoea in children and adolescents with obesity
M. Behrens
1   Universitätsklinik und Poliklinik für Kinder und Jugendliche, Universität Leipzig
,
A. Körner
1   Universitätsklinik und Poliklinik für Kinder und Jugendliche, Universität Leipzig
,
F. Pulzer
1   Universitätsklinik und Poliklinik für Kinder und Jugendliche, Universität Leipzig
,
W. Kiess
1   Universitätsklinik und Poliklinik für Kinder und Jugendliche, Universität Leipzig
› Author Affiliations
Further Information

Publication History

Publication Date:
21 December 2017 (online)

Zusammenfassung

Die Ätiologie des obstruktiven Schlafapnoesyndroms (OSAS) ist multifaktoriell. Vermutet wird eine komplexe Interaktion zwischen anatomischen und neuromuskulären Faktoren und einer genetischen Prädisposition sowie Übergewicht, Hormonen, Schlafdauer und inflammatorischen Zytokinen. Adipositas ist ein Gesundheitsproblem, das nahezu jedes Organsystem betrifft. Übergewichtige Kinder habe eine höhere Prävalenz als normalgewichtige Kinder für ein OSAS. Unbehandelt führt ein OSAS bei Kindern zu neurokognitiven Defiziten sowie kardiovaskulären und metabolischen Spätkomplikationen.

Summary

The etiology of obstructive sleep apnoea (OSA) is multifactorial. Researchers assume a complex interplay between anatomic and neuromuscular factors and an underlying genetic predisposition toward this disease. Other interplayers are obesity, hormones, sleep duration and inflammatoric cytokines. Obesity is a major health problem that affects nearly every major organ system. A high prevalence of OSA has been reported in obese children. Untreated, OSA in children is associated with neurocognitive deficits and cardiovascular and metabolic sequelae.

 
  • Literatur

  • 1 Aljadeff G, Gozal D, Schechtman VL. et al. Heart rate variability in children with obstructive sleep apnea. Sleep 1997; 20 (02) 151-157.
  • 2 Amin RS, Carroll JL, Jeffries JL. et al. Twentyfour-hour ambulatory blood pressure in children with sleep-disordered breathing. Am J Respir Crit Care Med 2004; 169 (08) 950-956.
  • 3 Amin RS, Kimball TR, Bean JA. et al. Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 2002; 165 (10) 1395-1399.
  • 4 Amin RS, Kimball TR, Kalra M. et al. Left ventricular function in children with sleep-disordered breathing. Am J Cardiol 2005; 95 (06) 801-804.
  • 5 Capdevila OS, Kheirandish-Gozal L, Dayyat E, Gozal D. Pediatric obstructive sleep apnea: complications, management, and long-term outcomes. Proc Am Thorac Soc 2008; 05 (02) 274-282.
  • 6 Castronovo V, Zucconi M, Nosetti L. et al. Prevalence of habitual snoring and sleep-disordered breathing in preschool-aged children in an Italian community. J Pediatr 2003; 142 (04) 377-382.
  • 7 Chau KW, Ng DK, Kwok CK. et al. Clinical risk factors for obstructive sleep apnoea in children. Singapore Med J 2003; 44 (11) 570-573.
  • 8 Chay OM, Goh A, Abisheganaden J. et al. Obstructive sleep apnea syndrome in obese Singapore children. Pediatr Pulmonol 2000; 29 (04) 284-290.
  • 9 Chen W, Bao W, Begum S. et al. Age-related patterns of the clustering of cardiovascular risk variables of syndrome X from childhood to young adulthood in a population made up of black and white subjects: the Bogalusa Heart Study. Diabetes 2000; 49 (06) 1042-1048.
  • 10 de la Eva RC, Baur LA, Donaghue KC, Waters KA. Metabolic correlates with obstructive sleep apnea in obese subjects. J Pediatr 2002; 140 (06) 654-659.
  • 11 Fregosi RF, Quan SF, Kaemingk KL. et al. Sleep-disordered breathing, pharyngeal size and soft tissue anatomy in children. J Appl Physiol 2003; 95 (05) 2030-2038.
  • 12 Galal MO, Amin M, Hussein A. et al. Left ventricular dysfunction after closure of large patent ductus arteriosus. Asian Cardiovasc Thorac Ann 2005; 13 (01) 24-29.
  • 13 Gellner R, Domschke W. Epidemiology of obesity. Chirurg. 2008
  • 14 Goh DY, Galster P, Marcus CL. Sleep architecture and respiratory disturbances in children with obstructive sleep apnea. Am J Respir Crit Care Med 2000; 162 (2 Pt 1): 682-626.
  • 15 Gozal D, Wang M, Pope Jr DW. Objective sleepiness measures in pediatric obstructive sleep apnea. Pediatrics 2001; 108 (03) 693-697.
  • 16 Gozal D, Crabtree VM, Sans OCapdevila. et al. C-reactive protein, obstructive sleep apnea, and cognitive dysfunction in school-aged children. Am J Respir Crit Care Med 2007; 176 (02) 188-193.
  • 17 Ievers-Landis CE, Redline S. Pediatric sleep apnea: implications of the epidemic of childhood overweight. Am J Respir Crit Care Med 2007; 175 (05) 436-441.
  • 18 Ip MS, Lam B, Ng MM. et al. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002; 165 (05) 670-676.
  • 19 Jackson-Leach R, Lobstein T. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing. Int J Pediatr Obes 2006; 01 (01) 26-32.
  • 20 Kaditis AG, Alexopoulos EI, Damani E. et al. Obstructive sleep-disordered breathing and fasting insulin levels in nonobese children. Pediatr Pulmonol 2005; 40 (06) 515-523.
  • 21 Katz ES, D’Ambrosio CM. Pathophysiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc 2008; 05 (02) 253-262.
  • 22 Kheirandish-Gozal L, Sans OCapdevila, Kheirandish E, Gozal D. Elevated serum aminotransferase levels in children at risk for obstructive sleep apnea. Chest 2008; 133 (01) 92-99.
  • 23 Korner A, Kratzsch J, Gausche R. et al. New predictors of the metabolic syndrome in children - role of adipocytokines. Pediatr Res 2007; 61 (06) 640-645.
  • 24 Li AM, Chan MH, Chan DF. et al. Insulin and obstructive sleep apnea in obese Chinese children. Pediatr Pulmonol 2006; 41 (12) 1175-1181.
  • 25 Lobstein T, Jackson-Leach R. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 2. Numbers of children with indicators of obesity-related disease. Int J Pediatr Obes 2006; 01 (01) 33-41.
  • 26 Marcus CL, Greene MG, Carroll JL. Blood pressure in children with obstructive sleep apnea. Am J Respir Crit Care Med 1998; 157 (4 Pt 1): 1098-1103.
  • 27 Marcus CL, Curtis S, Koerner CB. et al. Evaluation of pulmonary function and polysomnography in obese children and adolescents. Pediatr Pulmonol 1996; 21 (03) 176-183.
  • 28 McColley SA, Carroll JL, Curtis S. et al. High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea. Chest 1997; 111 (01) 170-173.
  • 29 Ng DK, Chow PY, Chan CH. et al. An update on childhood snoring. Acta Paediatr 2006; 95 (09) 1029-1035.
  • 30 O’Brien LM, Gozal D. Autonomic dysfunction in children with sleep-disordered breathing. Sleep 2005; 28 (06) 747-752.
  • 31 O’Brien LM, Serpero LD, Tauman R, Gozal D. Plasma adhesion molecules in children with sleep-disordered breathing. Chest 2006; 129 (04) 947-953.
  • 32 Owens JA, Spirito A, McGuinn M, Nobile C. Sleep habits and sleep disturbance in elementary school-aged children. J Dev Behav Pediatr 2000; 21 (01) 27-36.
  • 33 Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring) 2008; 16 (03) 643-653.
  • 34 Punjabi NM, Polotsky VY. Disorders of glucose metabolism in sleep apnea. J Appl Physiol 2005; 99 (05) 1998-2007.
  • 35 Redline S, Storfer-Isser A, Rosen CL. et al. Association between metabolic syndrome and sleep-disordered breathing in adolescents. Am J Respir Crit Care Med 2007; 176 (04) 401-408.
  • 36 Rosen CL, Larkin EK, Kirchner HL. et al. Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: association with race and prematurity. J Pediatr 2003; 142 (04) 383-389.
  • 37 Sargi Z, Younis RT. Pediatric obstructive sleep apnea: current management. ORL J Otorhinolaryngol Relat Spec 2007; 69 (06) 340-344.
  • 38 Schechter MS. Technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2002; 109 (04) e69.
  • 39 Silvestri JM, Weese-Mayer DE, Bass MT. et al. Polysomnography in obese children with a history of sleep-associated breathing disorders. Pediatr Pulmonol 1993; 16 (02) 124-129.
  • 40 Speiser PW, Rudolf MC, Anhalt H. et al. Childhood obesity. J Clin Endocrinol Metab 2005; 90 (03) 1871-1887.
  • 41 Tauman R, Gozal D. Obesity and obstructive sleep apnea in children. Paediatr Respir Rev 2006; 07 (04) 247-259.
  • 42 Tauman R, Ivanenko A, O’Brien LM, Gozal D. Plasma C-reactive protein levels among children with sleep-disordered breathing. Pediatrics 2004; 113 (06) e564-e569.
  • 43 Tauman R, O’Brien LM, Ivanenko A, Gozal D. Obesity rather than severity of sleep-disordered breathing as the major determinant of insulin resistance and altered lipidemia in snoring children. Pediatrics 2005; 116 (01) e66-e73.
  • 44 Tauman R, Serpero LD, Capdevila OS. et al. Adipokines in children with sleep disordered breathing. Sleep 2007; 30 (04) 443-449.
  • 45 Van Cauter E, Knutson K. Sleep and the epidemic of obesity in children and adults. Eur J Endocrinol. 2008
  • 46 Verhulst SL, Schrauwen N, Haentjens D. et al. Sleep-disordered breathing and the metabolic syndrome in overweight and obese children and adolescents. J Pediatr 2007; 150 (06) 608-612.
  • 47 Verhulst SL, Aerts L, Jacobs S. et al. Sleep-Disordered Breathing, Obesity and Airway Inflammation in Children and Adolescents. Chest. 2008