Children with OSAS Have Diminished Mucosal Sensation

Do children with obstructive sleep apnea syndrome (OSAS) have diminished upper airway sensation compared with controls?

Background: Studies have shown that attenuation of the upper airway mucosal sensation by topical anesthesia increases the tendency of upper airway collapse. These findings suggest that impairment of upper airway mucosal sensation may contribute to upper airway collapse in sleep apnea. Previous studies in adults have demonstrated impaired mucosal sensory function in subjects with OSAS.

Study Design: Prospective case-control study

Setting: Children’s Hospital of Philadelphia

Synopsis: Researchers studied thirteen subjects ages six to 16 with OSAS (apnea-hypopnea index 31±48) and nine normal controls (apnea-hypopnea index 0.4±0.5) who were age-, gender- and body mass index (BMI)-matched. The children were tested while awake using two-point discrimination testing of the mucosa of the anterior tongue and posterior hard palate. Children with OSAS had impaired two-point discrimination of the anterior tongue (p=0.002) and the palate (p<0.0001) when compared to controls. These two areas are supplied by nerves that have been described as part of the afferent innervations of the upper airway negative pressure reflex.

Further study is needed to determine if these findings are due to a congenital abnormality or are secondary to selective nerve damage caused by chronic snoring or mouth breathing. Post-treatment studies are needed to determine if these changes are reversible and to elucidate the pathophysiology of upper airway sensory function in children.

Bottom line: Children with OSAS do have diminished mucosal sensation in the tongue and palate compared to age-, gender- and BMI-matched controls.

Citation: Tapia IE, Bandia P, Traylor J, et al. Upper airway sensory function in children with obstructive sleep apnea syndrome. Sleep. 2010:33(7):968-972.

—Reviewed by Pell Wardrop, MD