Evaluation of children with chronic cough including obstructive sleep apnea: a single-center experience. Eur J Pediatr 2019 Feb;178(2):189-197
Date
11/02/2018Pubmed ID
30382346DOI
10.1007/s00431-018-3276-xScopus ID
2-s2.0-85055991254 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
Chronic cough in children may be due to a diverse range of etiologies. We aimed to evaluate children with chronic cough following a standardized cough algorithm and assess obstructive sleep apnea (OSA) as a possible etiology. In addition, cough resolution rates of two different treatment protocols in children with non-specific cough were compared. A total of 237 children referred for chronic cough were assessed and classified according to etiologies. Children with non-specific cough were assigned either in the early-arm (group-1, n = 13) or delayed arm (group-2, n = 23). The presence of OSA was evaluated using a pediatric sleep questionnaire, and polysomnography was handled in indicated patients. Asthma (n = 82) and protracted bacterial bronchitis (PBB) (n = 73) were the most frequent etiologies. Cough resolution was higher in group-1 (100%) compared with group-2 (50%) (absolute risk reduction (rr) = 43.48% [95% CI 21.38-65.58%]). Polysomnography revealed mild (n = 6), moderate (n = 7), or severe (n = 5) OSA in 18 children, with adenoid/adenotonsillary hypertrophy as the leading cause.Conclusion: We recognized asthma and PBB as the most frequent causes of chronic cough in our cohort. Early treatment of patients with high parental anxiety might be beneficial. We also believe that further studies including larger series might eventuate in incorporation of assessment of OSA to standardized algorithms. What is known? • Chronic cough in children may be due to a diverse range of etiologies, including serious respiratory disorders. Thus, its correct diagnosis and treatment are essential. • Although a well-defined reason of chronic cough in adults, obstructive sleep apnea (OSA) has not been been evaluated so far in children with chronic cough. What is new? • We examined OSA for the first time as a possible cause of chronic cough in children and detected OSA with polysomnography in cases who scored high pediatric sleep questionnaire (PSQ) scores. • We believe that studies including larger series might eventuate in incorporation of assessment of OSA to standardized algorithms for children with chronic cough.
Author List
Ilarslan NEC, Gunay F, Haskologlu ZS, Bal SK, Tezcaner ZC, Kirsaclioglu CT, Firat S, Altuntas C, Ciftci B, Ozgursoy OB, Cobanoglu NAuthor
Selim Firat MD Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAlgorithms
Child
Child, Preschool
Chronic Disease
Cohort Studies
Cough
Female
Follow-Up Studies
Humans
Infant
Male
Polysomnography
Prospective Studies
Sleep Apnea, Obstructive
Surveys and Questionnaires
