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Sleep apnoea: surge in number of children admitted to hospital

A child on bathroom scales
There are 124 million obese children worldwide. More than a million of them live in the UK. Photograph: Chris Radburn/PA

The number of admissions to hospital of children and teenagers with sleep apnoea has risen sharply over the past four years, with experts suggesting childhood obesity is to blame.

Data from NHS Digital, the national information and technology partner to the health and social care system, shows that admissions with a primary diagnosis of sleep apnoea, a serious disorder that occurs when breathing is interrupted at night, reached a peak of 7,557 in 2016-17, up from 5,675 in 2012-13.

Doctors and charities said the increase in admissions was linked to epidemic levels of obesity in young people, adding that increased awareness was also a factor in the rise.

“The numbers rising is not surprising in the context of the obesity problem – it goes hand in hand. These are two related issues,” said Joerg Steier, a consultant physician in respiratory medicine at Guy’s and St Thomas’ NHS foundation trust.

“Obesity puts an increased load on the upper airway and the airway becomes collapsable, which increases the chances of sleep apnoea as it means less air can travel through.”

Steier said anyone with sleep apnoea would need to identify the problem and seek treatment but, in terms of addressing the public health issues linked to it, tackling the “obesity epidemic” was essential.

There are 124 million obese children worldwide, a more than tenfold increase in four decades. More than a million of them live in the UK, which has the worst obesity rates in western Europe.

“We as a population need to get a grip on the childhood obesity epidemic and anything that [will help to] bring down the prevalence of sleep apnoea and other associated comorbidities,” Steier said.

Obstructive sleep apnoea, the main affliction of sleep apnoea, is a potentially serious disorder that causes breathing to repeatedly stop during sleep. It happens when the throat muscles intermittently relax and block the airway.

If obstructive sleep apnoea is not treated, it can increase the risk of developing high blood pressure, a stroke or heart attack.

Dr Catherine Hill, a consultant in paediatric sleep medicine at Southampton children’s hospital, said it was good that obstructive sleep apnoea was increasingly being recognised as in the past it has been overlooked because it is present at night.

“A child presenting to GP in the day may have little to see, and we know that examination of the child in the day may be normal,” she said. The result of the condition would be disrupted sleep, which could lead to other health and behavioural problems.

“The epidemic of obesity in the UK is leading to us now seeing children who need supportive non-invasive ventilation to treat their sleep apnoea at night,” Hill said.

Non-invasive ventilation involves wearing a mask that blows air at high pressure into the nose, splinting the airway open.

Chris Rogers, the managing secretary of the Sleep Apnoea Trust, said sleep apnea was growing among all ages, and was a bigger problem than NHS statistics might suggest.

“Estimates [of the numbers] by the NHS for adults are quite out of date. New research estimates in the US it’s 13% of adult males and 6% adult women, and we now use figures in the UK of up to 13% and up to 6%, because in terms of obesity-related sleep apnoea we are somewhat behind the US.

“The current estimate that there are 1.5 million who have sleep apnoea is inadequate – the figure now is more like 3.9 million.”