Nose spray reduces childhood apnea-linked inflammation

Early research shows certain steroid nasal sprays may help to reduce the inflammatory cell proteins in children that are linked to sleep apnea. A study included in the June of Archives of Otolaryngology – Head & Neck Surgery looked at how children who were due to have their adenoids and tonsils removed reacted to the drug fluticasone furoate.

The study involved 24 children from the ages of 2 to 12 years old, with sleep apnea. The children were divided into two groups. About half of the children received doses of the nasal spray once a day for two weeks prior to surgery. The control group did not use the nasal spray.

After children in both groups had their adenoids and tonsils surgically removed, the researchers examined the adenoids. While all of the adenoids weighed about the same, the treatment group had lower levels of the inflammatory cell protein IL-6. The cell protein has been linked to the development of sleep apnea.

In the study’s conclusion, the authors stated that steroid nasal spray could potentially be part of future pediatric sleep apnea treatments. The findings support previous research that found nasal fluticasone reduced the frequency of breathing pauses in children with obstructive sleep apnea in children.

The research is still in its early phases and parents should be aware that steroid nasal sprays are not a recognized obstructive sleep apnea treatment for children. The standard treatments include surgery, CPAP and weight loss. Some children with sleep apnea may benefit from wearing an oral appliance during sleep.

The American Academy of Sleep Medicine reports that about two percent of healthy young children have sleep apnea. The sleep disorder occurs when soft tissue in the back of throat collapses and blocks the airway during sleep.

Most children with sleep apnea have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

Read more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Photo by: olaerik

CPAP Therapy: Reducing Nasal Congestion

A new study from Ireland evaluated methods to improve nasal symptoms in people using CPAP therapy for obstructive sleep apnea. The results were published yesterday in the Journal of Clinical Sleep Medicine.

The study involved 112 people; most of the participants were men. On average they were obese and had severe sleep apnea.

They were randomly assigned to one of three CPAP therapy groups: dry CPAP, CPAP with a humidifier or CPAP with a nasal steroid spray.

After one month of treatment, quality of life was improved in all three groups. Fatigue and daytime sleepiness also decreased. All groups used CPAP for an average of more than five hours per night.

People who used “dry” CPAP were least likely to have itchy or watery eyes. But they were most likely to have nasal congestion. At the end of the study 70 percent of this group continued with dry CPAP; the others added a heated humidifier or a nasal steroid spray.

People who used CPAP with a heated humidifier were least likely to have nasal congestion. But eight of these people were unable to tolerate the humidifier; they all switched to dry CPAP. At the end of the study 46 percent of this group continued with a humidifier; the others switched to dry CPAP or added a nasal steroid spray.

The other group used CPAP and a nasal spray with fluticasone, a steroid; they used the spray two times a day. They were most likely to have problems with sneezing and runny nose; but the sneezing stopped within a few minutes of application. At the end of the study only 35 percent of this group continued with the nasal spray; the others switched to dry CPAP or added a humidifier.

The authors conclude that people who use CPAP should be evaluated on an indi­vidual basis; some may benefit from the addition of a heated humidifier or topical steroid spray.

Talk to your CPAP supplier if you have questions or concerns about the treatment. Call your sleep center if you have ongoing problems with CPAP therapy.

Get tips for solving CPAP problems on SleepEducation.com. Contact an AASM-accredited sleep center near you for help with sleep apnea.