Childhood obesity is a risk factor for the development of (SHAHS) sleep apnea hypopnea syndrome

March 16, 2012, world sleep day

-usual night snoring, interrupted sleep and daytime behavior problems are some of the symptoms of the SHAHS

-the risk of developing severe cardiovascular or metabolic disorders is higher in children with obesity

-adult patients with apnea have a higher prevalence of stroke

Spain, March 2012.- within the framework of the world sleep dayon 16 March, the Spanish sleep society (SES) is willing to contribute to the dissemination of the importance of respiratory disorders of sleep in our society. The SHAHS is defined as a disorder of breathing during sleep characterized by a partial or complete and prolonged blockage of the upper airway, made that leads to an alteration of the normal ventilation during sleep. Its main symptoms are usual night snoring (often with intermittent breaks, snorting or gasps), sleep disorders and behavioral problems day caused by existing patterns of sleep disorder.

Patients suffering from respiratory sleep disorders are more susceptible to other diseases related to other systems. Especially, there is a very high risk of cerebrovascular problems at the same time at adult ages, and cardiovascular, such as ischaemic diseases of the heart or cerebral vascular accidents. Also, the symptoms produced by the sleep apnea, also may be increased if the patient is already suffering from other diseases, such as obesity, especially in children’s ages.

According to a research on obesity and child SHAHS by pediatrician David Gozal, and published in Pediatric Pulmonology, estimated a 2 and 3% of the total child population suffering SHAHS, with a peak of prevalence between 2 and 8 years of age, establishing as well as one of the most common childhood diseases. Despite such evidence, this disease is still infradiagnosticada and less than 30% of medical professionals perform routine detection of snoring in children age school and adolescents.

Note, that at the same time, obesity is one of the most common diseases in the northern hemisphere and its prevalence continues moving, especially at a very young age. In addition to psychological disorders that can develop in an obese child, such as depression or poor social relations, there is a very high risk of gastrointestinal complications that can lead to liver disease and several other co-morbidities, such as irritable bowel syndrome. Also, obese children have a higher risk of several disorders, especially those affecting the cardiovascular and metabolic systems. The simultaneous presence of obesity and other diseases generated by the increase in body fat represent a latent risk of accentuating (SHAHS) sleep apnea-hypopnea syndrome.

Both diseases start to develop very early in life, children, although the true impact of inflammatory diseases is evident in the long term, in adulthood.

Such clinical findings should alert health workers that the recognition and treatment of obesity and the SHAHS active search in obese children sleep apnea is of utmost importance and urgency in children, in the same way that it is necessary that more than 40% of obese children suffer respiratory sleep disorders and the prevalence of snoring in the obese child general population is over 50%, according to NANOS extracted study data, a cooperative study by Spanish researchers.

The accumulation of morbidities increases the risk of mortality, in the same way that increases the inflammatory mediators, fact that determines a cardiovascular and endothelial and dysfunction, in some cases, the appearance of diabetes and insulin resistance. In this sense, the relationship between obesity and the SHAHS and its linkage to many common routes that lead to the induction of chronic inflammation in children remains evident.

A study conducted by the area of dream of the Spanish society for Pneumology and thoracic surgery published in Sleep Medicine on the role of the & polygraphy type simplified methods of diagnosis demonstrates that detection of the adenoamigdalectomia and the SHAHS residual is becoming increasingly more effective. This type of simplified diagnosis shows that the & polygraphy is increasingly effective for the indication of adenotonsillectomy and residual diagnosis of SHAHS. It is very effective and, in children, home is used.

On the other hand, the respiratory sleep disorders tend to increase with age, and affect a wide range of adult population. SHAHS patients have higher risk of cerebral vascular accidents (AVC). The annual incidence of AVC is 2 to 18 x 1000 inhabitants and is the second leading cause of death in the world and the first of disability. Recent studies show that 63% of patients who have suffered an AVC have a SHAHS.

The SHAHS has established itself as a risk factor for suffering an AVC. So that the risk of an AVC increases up to 6 times in adults who have a serious SHAHS and not only that, but that also increases the risk of recurrence. Apneas CPAP treatment reduces the risk of cerebrovascular events to a minimum.

According to the Spanish Neurology Society (SEN), there is a latent need for more studies in this direction, focusing on the improvement of the accession and tolerance of CPAP treatment in patients with AVC with the purpose to offer patients a better quality of life.

Apnea syndrome of the dream (SHAHS) affects 4 / 6% of the general population. Patients with this disorder not only presented a deterioration in their quality of life, but that have an increased risk of cardiovascular diseases such as: myocardial infarction, arrhythmias, metabolic syndrome and arterial hypertension. Treatment with CPAP improves the quality of life of those who suffer from SHAHS and decreases the risk of all these associated pathologies, what important saving costs sociosanitarios.