Narrow throat may cause sleep apnea

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Narrow throat may cause sleep apnea

By Emma Hitt, PhD

NEW YORK, Feb 06 (Reuters Health) - Although snoring is often linked to

obesity, new study findings suggest that a narrow throat, which can be

inherited, may also cause snoring and a problematic breathing disorder

called obstructive sleep apnea (OSA).

OSA is caused by a blockage of the upper airway resulting in cessation

of breathing during sleep dozens of times per night. If left untreated,

it can cause excessive daytime sleepiness, as well as hyperactivity and

behavior problems in children.

Typically, OSA strikes obese middle-aged men, but it is estimated to

afflict as much as 3% of the population, including children.

According to Dr. R. Stradling and colleagues from Oxford

University, UK, the most common reason for a narrowing of the throat

during sleep, a cause of OSA, is enlarged tonsils and adenoids, so the

researchers wanted to see whether children who had had their tonsils and

adenoids removed experienced OSA 12 years later.

" Enlarged tonsils occupy a significant space in the throat and narrow

the airway, " Stradling told Reuters Health. " With the normal narrowing

that occurs with sleep, the space gets critically small. "

Stradling and colleagues evaluated the nighttime breathing of 20

teenagers who had had their tonsils and adenoids removed 12 years

earlier when they were about 4 years old. The children had all been

snorers and had had repeated bouts of enlarged tonsils before surgery.

The investigators compared the nighttime breathing of these teens with

that of 20 healthy teens for whom breathing data were also collected 12

years earlier.

Writing in the January issue of the Archives of Disease in Childhood,

the researchers report that many of the teens who had had their tonsils

out 12 years earlier showed signs of sleep apnea, suggesting that they

may have a narrow throat persisting into adulthood.

The nasal blockage and adenoidal swelling experienced by the teens

during childhood might, by causing them to breathe through their mouths,

" lead to the very changes in lower facial shape...that are thought to

contribute to airway crowding, " the authors note. Helping these children

to breathe through their noses rather than their mouths could prevent

these facial changes from occurring, they add.

" These findings are one further piece of evidence that a predisposition

to snoring and OSA in both children and adults may result from the

common risk factor of a small upper airway, " Stradling's team concludes.

SOURCE: Archives of Disease in Childhood 2002;86:34-37.