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Children with obstructive sleep apnea (OSA) face a significantly elevated risk of contracting influenza and COVID-19, according to a new five-year study. Researchers found that children with OSA were more than twice as likely to be diagnosed with either viral infection, regardless of age or weight. The study also revealed that this increased susceptibility persists even after common surgical interventions like tonsil and adenoid removal, pointing to long-term immune system changes triggered by the sleep disorder.
The findings, published in the Journal of Clinical Sleep Medicine, the official publication of the American Academy of Sleep Medicine, underscore the importance of recognizing sleep apnea as a potential risk factor for respiratory infections and highlight the need for proactive preventative measures, particularly vaccination. Researchers are now framing a diagnosis of sleep apnea as a critical “risk marker” for increased vulnerability to seasonal viruses.
Obstructive sleep apnea, characterized by repeated interruptions in breathing during sleep, is often associated with snoring and daytime fatigue. However, this research reinforces growing evidence that the condition extends beyond these common symptoms, impacting the body’s immune defenses. The study analyzed data from over 1 million children aged 2 to 18, utilizing the TriNetX global health database.
Immune System Disruption Linked to Increased Risk
The study revealed a stark difference in infection rates between children with and without OSA. Children with sleep apnea had an 80% higher risk of contracting influenza compared to their peers without the condition. The risk for COVID-19 was even more pronounced, with children diagnosed with OSA being approximately 2.5 times more likely to test positive for the virus. The research indicated a significantly higher likelihood of developing pneumonia as a complication of these viral infections in children with OSA.
Researchers believe this heightened vulnerability stems from a disruption in the immune system’s function. Dr. Alex Gileles-Hillel, a lead researcher on the study, explained that “the dysregulation of innate and adaptive immune milieus in pediatric OSA may explain both the increased susceptibility to viral infection and the more severe symptoms that prompt medical attention.” This immune dysregulation appears to impair the body’s ability to effectively fight off viral invaders.
Surgery Doesn’t Eliminate the Risk
Many parents seek adenotonsillectomy – the surgical removal of tonsils and adenoids – as a treatment option for their child’s sleep apnea. However, the study found that this procedure did not significantly reduce the increased risk of viral infection. Dr. David Gozal explained this finding may be due to two factors: a substantial number of children continue to experience residual sleep apnea even after surgery, and OSA-related immune dysregulation can persist, hindering the body’s ability to mount an appropriate immune response. “We are actively working on understanding this immune-related susceptibility,” Dr. Gozal added.
Sleep Apnea as a Preventative Health Flag
The researchers emphasize that a diagnosis of sleep apnea should be viewed as a signal for prioritizing preventative healthcare measures. Dr. Joel Reiter stressed the importance of considering sleep apnea a “practical flag” for preventive health, advocating for prioritizing annual vaccinations for children diagnosed with the condition. Dr. Alex Gileles-Hillel suggests that “framing OSA as a ‘risk marker’ may help overcome hesitancy during routine pediatric counseling,” encouraging clinicians to prioritize seasonal influenza vaccination at the time of diagnosis, similar to recommendations for other respiratory conditions like asthma.
This research underscores the complex interplay between sleep, immunity, and respiratory health in children. Further investigation is needed to fully understand the mechanisms driving immune dysregulation in pediatric OSA and to develop targeted interventions to mitigate the increased risk of viral infections. Ongoing studies are focused on identifying specific immune pathways affected by OSA and exploring potential therapeutic strategies to restore immune function.
As we move forward, recognizing sleep apnea as a potential risk factor for severe respiratory illness will be crucial for protecting vulnerable children and optimizing preventative care strategies. Share this information with your network and discuss any concerns about your child’s sleep health with their pediatrician.
Disclaimer: This article provides informational content and should not be considered medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.
