Thursday, August 25, 2011

Urinary Leukotrienes and Pediatric Obstructive Sleep Apnea

Pediatric obstructive sleep apnea (OSA) is on the rise, especially as our children struggle more with obesity. Kids that have enlarged tonsils and/or adenoids are also at risk for OSA. Some researchers believe inflammation plays a role in OSA as well. There is a study in the Sleep Journal about leukotrienes, which are markers of inflammation. The study included 282 children aged 2 to 12 years old who snored regularly at least 4 nights per week. All of the children had sleep studies to check for OSA. On the morning after the sleep study, the researchers measured a specific leukotriene, aka LTE4, in their urine.

The results showed that the more severe the OSA (defined as mild, moderate, or severe), the higher the LTE4 levels. Also, urinary LTE4 levels were higher in the children with OSA that were overweight versus normal weight children with OSA. Finally, there was an association between enlarged adenoids / tonsils and OSA, but only for normal weight children.

The researchers theorized that the broken up sleep and low oxygen levels caused by OSA was linked with the elevated LTE4 levels - and this marker of inflammation was elevated even in mild OSA. However, they were unable to determine if the elevated LTE4 levels come before or after the children developed OSA. The researchers speculated that perhaps medications that block leukotrienes could be used in the management of pediatric OSA, such as in normal weight patients with milder cases.

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