Evaluation of children with chronic cough including obstructive sleep apnea: a single-center experience


İLARSLAN N. E. Ç. , GÜNAY F., Haskologlu Z. S. , Bal S. K. , Tezcaner Z. C. , Kirsaclioglu C. T. , ...More

EUROPEAN JOURNAL OF PEDIATRICS, vol.178, no.2, pp.189-197, 2019 (Journal Indexed in SCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 178 Issue: 2
  • Publication Date: 2019
  • Doi Number: 10.1007/s00431-018-3276-x
  • Title of Journal : EUROPEAN JOURNAL OF PEDIATRICS
  • Page Numbers: pp.189-197

Abstract

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?center dot 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.center dot 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?center dot 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.center dot We believe that studies including larger series might eventuate in incorporation of assessment of OSA to standardized algorithms for children with chronic cough.