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 indices were 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 SpO(2), ETCO(2), and sleep indices. CONCLUSIONS: RSV bronchiolitis may contribute to the pathophysiology of OSA in vulnerable children.