Outcomes of Intranasal Corticosteroid Treatment and Associated Factors in Children With Clinically Diagnosed Obstructive Sleep Apnea

Abstract

Background and Objective Many studies have supported the potential effect of anti-inflammatory medications treatment for childhood obstructive sleep apnea (OSA). This study aimed to evaluate the outcomes of intranasal corticosteroid treatment in children with OSA symptoms and adenoid hypertrophy (AH), and to identify factors associated with the treatment outcome.Methods This retrospective study included children aged 1–15 years who snored, had sleeprelated symptoms, and received intranasal corticosteroid treatment for 4–16 weeks. Treatment outcome was considered a success if all symptoms were completely resolved or if the child still snored without sleep-related symptoms; treatment was considered a failure if the child still snored and had concomitant sleep-related symptoms.Results Among the 328 eligible children, 109 (33.2%) experienced treatment failure. The age of the children was significantly higher in the failure group than in the success group (median [interquartile range], 5.5 [3.4, 8.4] vs. 4.2 [3.2, 6.3]; p = 0.004). The percentage of children with allergic rhinitis (AR) symptoms at follow-up visit was also significantly higher in the failure group than in the success group (44% vs. 27.9% with mild AR and 9.2% vs. 4.1% with moderateto-severe AR, p < 0.001). Multiple logistic regression revealed a significant association between treatment failure and older age (odds ratio [95% confidence interval], 1.13 [1.04–1.23]) and presence of mild AR (2.29 [1.39–3.77]) and moderate-to-severe AR (3.17 [1.20–8.39]).Conclusions Among children with OSA and AH, one-third experienced treatment failure, and the associated factors were older age and presence of AR symptoms.