Socially vulnerable children with sleep apnoea had more asthma and more surgery

Design

Retrospective institutional database cohort

Population

5,753 children aged 0–18 with obstructive sleep apnoea

Primary outcome

Comorbidities, testing and surgery by social vulnerability quartile

Effect

Asthma 9.4% in highest-vulnerability group; higher adenotonsillectomy rates

A US institutional database study grouped 5,753 children with obstructive sleep apnoea by neighbourhood Social Vulnerability Index.

Comorbid asthma rose stepwise with vulnerability, to 9.4% in the most vulnerable group. Children in the most vulnerable quartile had adenotonsillectomy more often than those in the two least vulnerable quartiles. Only 8.7% overall had polysomnography, with no difference by vulnerability, and mean time to surgery was about 166 days in all groups.

The authors suggest these children present with more severe disease. The data cannot confirm that, since severity measures were limited, but the asthma overlap is a useful prompt in clinic.

• Ask about asthma symptoms in children referred with snoring or sleep apnoea
• Coordinate airway care with the child's GP or paediatrician where asthma coexists
• Consider family barriers to follow-up when planning surgery and review
• Use sleep study access where available, as most children here had none

Why it matters

It points to a group in whom sleep apnoea and asthma cluster and may be more severe.

Don't overread it

An observational database study — it cannot show that social vulnerability causes more severe sleep apnoea.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.