ASPO025 - Vitamin D deficiency and increased pediatric obstructive sleep apnea severity
Saturday, April 30, 2022
1:55 PM – 2:30 PM CT
Location: Landmark C
Andrew E. Bluher, M.D.1, Timothy Kearney, M.S.2, Addy Tham, B.S.2, Turaj Vazifedan, M.S.2, Cristina M. Baldassari, M.D.3;
1Otolaryngology–Head and Neck Surgery, Washington Univ., St. Louis, MO, 2Eastern Virginia Med. Sch., Norfolk, VA, 3Otolaryngology–Head and Neck Surgery, Eastern Virginia Med. Sch., Norfolk, VA.
Assistant Professor Washington University in St. Louis
Vitamin D deficiency and increased pediatric obstructive sleep apnea severity
INTRODUCTION: Vitamin D deficiency has been linked to several chronic medical conditions in children, including asthma. Studies have demonstrated an association between Vitamin D deficiency and obstructive sleep apnea (OSA) in adults, but data about the relationship between vitamin D levels and pediatric OSA is still emerging. Thus, our primary objective is to evaluate the correlation between Vitamin D levels and the apnea hypopnea index (AHI) in children with OSA.
METHODS: Children 2 to 16 years of age with severe OSA (apnea hypopnea index >10 on polysomnogram) who were undergoing adenotonsillectomy were prospectively enrolled. Patients with neuromuscular, genetic, or craniofacial disorders were excluded. Fasting blood samples were collected; Vitamin D deficiency was defined as 25(OH) D level <20 ng/mL. Analyses were controlled for sex, race, age, tonsil size, history of prematurity, body mass index, history of asthma, and season.
RESULTS: 72 patients with a mean age of 6.7 years were included. The mean AHI was 43 and 49% (n=35) were obese. Approximately one third of children (n=27) had vitamin D deficiency. In univariate analysis, Vitamin D deficiency was associated with older age (diff=5, 95% CI (2.8, 7.2), p<0.001), black race (OR=0.23, 95% CI (0.07, 0.74)), female sex (OR=0.21, 95% CI (0.08, 0.59), p=0.002), and AHI (diff 13.8, 95% CI (-26.4, -1.2), p=0.03). On multivariate analysis, only AHI remained a significant predictor of low Vitamin D levels; an AHI increase by 0.8 unit was associated with a one unit decrease in vitamin D levels (95% CI (-1.5, -0.1), p=0.03).
CONCLUSION:Vitamin D deficiency is common in children undergoing adenotonsillectomy for severe OSA. Vitamin D deficiency is associated with increased OSA severity. Future research is needed to see if Vitamin D supplementation leads to improvements in pediatric OSA treatment outcomes.