What are the adverse effects of intermittent hypoxemia due to childhood obstructive sleep apnea (OSA)?

Updated: Feb 13, 2019
  • Author: Mary E Cataletto, MD; Chief Editor: Denise Serebrisky, MD  more...
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Answer

A serious consequence of intermittent hypoxia is elevation of pulmonary artery pressure due to pulmonary vasoconstriction, such that chronic intermittent nocturnal hypoxemia leads to development of pulmonary hypertension and cor pulmonale. In 27 pediatric patients with moderate-to-severe obstructive sleep apnea, radionuclide assessment of right ventricular function revealed reduced ejection fraction in 37% of these children and wall motion abnormality in 45%. [15] Another potentially serious consequence of intermittent hypoxia may involve its long-term deleterious effects on neuronal and intellectual function. Indeed, in a study on an animal model developed in the coauthor's laboratory, intermittent hypoxia was associated with significant increases in neuronal apoptosis and reduced functionality within brain regions that mediate learning and memory.

Because the peak age for obstructive sleep apnea coincides with that of a critical period for brain development, delayed diagnosis and treatment of obstructive sleep apnea possibly imposes a greater burden on vulnerable brain structures and ultimately hampers the overall neurocognitive potential of children with obstructive sleep apnea.

Neurobehavioral disturbances and diminished learning capabilities, stunted growth, altered respiratory load response patterns, and pulmonary hypertension are major consequences of obstructive sleep apnea in childhood. Early diagnosis and prevention of such morbidities are fundamental aspects of adequate pediatric care in the community.


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