Title: Association between Obstructive Sleep Apnea and Allergen Sensitization in Pediatric Asthmatic Patients.
Monday, March 5, 2018
South Hall A2 (Convention Center)
Yan Yan, MD, Sairaman Nagarajan, Haesoon Lee, MD, Emily Concepcion, MD, Maria-Anna Vastardi, MD
RATIONALE: Whether obstructive sleep apnea (OSA) is associated with presence of allergic disease is not fully known. Research has shown that allergic rhinitis is a risk factor for snoring in children and allergic rhinitis might worsen OSA in adults. However there have been no studies on the association between OSA and allergen sensitization in the pediatric age group.

METHODS: This is a retrospective case-control study (2010-2013) of pediatric asthma patients (1-21years) treated in a university based pediatric asthma clinic. OSA was diagnosed in 48 out of 78 patients who were referred for a sleep study with apnea hypopnea index (AHI) >1.5. Specific IgE for aeroallergen sensitization (ImmunoCAP®) was measured. Data were analyzed using t-tests and Chi-square tests.

RESULTS: 75% of children had a positive ImmunoCAP® test indicating sensitivity to allergens in our cohort. Patients with positive ImmunoCAP® tests had significantly higher hypopnea index (p=0.03) but not AHI. There were no significant differences in allergen sensitization, total IgE, absolute eosinophil count, eosinophil percentage, asthma severity or BMI in OSA group compared to non-OSA group. The most common sensitized allergens were dust mite and cockroaches in the OSA group and dust mite and mouse in non-OSA patients. There was higher prevalence in perennial allergen sensitization (dust mites and animal dander) in the non-OSA group compared to OSA group (60.7% vs 35.4% respectively, P=0.15).

CONCLUSIONS: Allergen sensitization complicates sleep disordered breathing with hypopneas but is not a significant risk factor for OSA in our cohort. A higher prevalence in perennial allergen sensitization was noted in non-OSA patients.