A new study has found that children diagnosed with obstructive sleep apnea (OSA) are about twice as likely to contract influenza or COVID-19 compared to children without the condition. The research was led by Dr. Alex Gileles-Hillel and Dr. Joel Reiter from the Faculty of Medicine at the Hebrew University, along with senior pediatric pulmonologists at Hadassah Medical Center and Dr. David Gozal from Marshall University. Their findings were published in the Journal of Clinical Sleep Medicine.
The study followed over 1 million children aged 2 to 18 years for five years using data from the TriNetX global health database. Researchers discovered that even after undergoing adenotonsillectomy—a common surgery to remove tonsils and adenoids used to treat OSA—children continued to face a higher risk of viral infections such as flu and COVID-19.
Dr. Alex Gileles-Hillel commented on these results: "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".
Despite many parents choosing adenotonsillectomy as a treatment for their child's sleep apnea, the procedure did not significantly reduce infection risks according to this study. Dr. David Gozal said this "may reflect two clinical and pathophysiological observations." He added that some children have residual sleep apnea after surgery, and "OSA-related immune dysregulation could impair the recruitment of an appropriate immune response. We are actively working on understanding this immune-related susceptibility."
The research team suggests that recognizing sleep apnea as a marker for increased risk could help guide preventive care measures for affected children, particularly regarding seasonal vaccinations against respiratory viruses.
Dr. Joel Reiter stated that prioritizing annual vaccinations is important because these children are at greater risk for contracting viruses and experiencing complications.
Dr. Alex Gileles-Hillel concluded: "framing OSA as a 'risk marker' may help overcome hesitancy during routine pediatric counseling". He recommended clinicians prioritize influenza vaccination when diagnosing sleep apnea, similar to protocols for other respiratory disorders like asthma.
