Pediatric obstructive sleep apnea: A potential late consequence of respiratory syncitial virus bronchiolitis

Study Objectives: To examine the hypothesis that children who suffered from severe respiratory syncitial virus (RSV) bronchiolitis during infancy may be at higher risk for obstructive sleep apnea (OSA) later in childhood. Methods: Survey of Kosair Children's Hospital medical records allowed for identification of potential candidates for the study. Twenty-one randomly selected children (mean age ± SD: 5.2 ± 1.5 years) with a history of verified RSV-induced bronchiolitis during their first year of life underwent overnight sleep study (NPSG).Children recruited from the general population with no history of RSV bronchiolitis served as a control group. After matching for age, gender, ethnicity, gestational age at birth, body mass index (BMI) z scores, household cigarette smoking, history of asthma and allergies, 63 control subjects (mean age ± SD: 5.1 ± 0.7 years) were also studied. Results: Children who had RSV bronchiolitis as infants had significantly higher obstructive apnea/hypopnea index compared to controls (2.3 ± 1.9 vs. 0.6 ± 0.8 / hr total sleep time (TST); P < 0.05). In addition, significantly higher respiratory arousal indiceswere apparent among children with previous RSV bronchiolitis compared to controls (1.3 ± 1.0 vs. 0.1 ± 0.2 /hr TST; P < 0.05). There were no significant differences between the groups in the lowest SpO², ETCO² , and sleep indices. Conclusions: RSV bronchiolitis may contribute to the pathophysiology of OSA in vulnerable children.