The bottom line: Children with obstructive sleep apnoea face a 1.8 times higher risk of influenza and a 2.5 times greater chance of Covid, persisting across all age groups and unaffected by common treatments like surgery, which points to underlying immune vulnerabilities that heighten everyday respiratory threats. This elevated susceptibility means families must prioritise preventive strategies to safeguard their child’s health, reducing the burden on well-being from frequent illnesses and potential complications like pneumonia. Healthcare providers should leverage sleep apnoea diagnoses to advocate strongly for vaccinations, framing the condition as a critical risk marker to inform public health policies and overcome hesitancy in immunisation uptake.
Parents of children struggling with obstructive sleep apnoea may need to be extra vigilant during flu season. A large-scale study has shown that these youngsters face a significantly higher chance of catching influenza or Covid, highlighting the real-world impact on family health and the need for preventive measures like vaccinations. This finding, published in the Journal of Clinical Sleep Medicine, underscores how common childhood conditions like sleep apnoea can amplify everyday risks from respiratory viruses.
The research tracked over a million children aged between 2 and 18 years over a five-year period. It compared those newly diagnosed with obstructive sleep apnoea to a matched group without the condition. Experts found that children with sleep apnoea were about 1.8 times more likely to be diagnosed with influenza and nearly 2.5 times more prone to Covid.
These elevated risks persisted across all age groups, from toddlers to teenagers. Even after accounting for factors like obesity, which often links to sleep apnoea in children, the patterns held firm. The study also examined severe outcomes, revealing a higher chance of pneumonia linked to these viruses among affected kids.
Surprisingly, common treatments did not seem to lower the vulnerability. Adenotonsillectomy, a surgery to remove enlarged tonsils and adenoids that is a standard fix for paediatric sleep apnoea, showed no significant reduction in infection risks. This suggests that underlying issues, such as ongoing immune system changes, might play a role beyond physical blockages in the airways.
Dr Alex Gileles-Hillel of Hadassah-Hebrew University Medical Center explained: “The dysregulation of innate and adaptive immune milieus in paediatric OSA may explain both the increased susceptibility to viral infection and the more severe symptoms that prompt medical attention.”
Obstructive sleep apnoea disrupts breathing during sleep, often leading to poor rest and daytime fatigue. Previous smaller studies hinted at weakened immune responses in these children, making them more susceptible to viruses. The new evidence builds on this, pointing to altered cellular immunity that could impair the body’s defences against common pathogens like flu and Covid.
Health experts are now calling for prioritised vaccinations for children with sleep apnoea. Seasonal flu jabs and Covid boosters could help mitigate the doubled risk, especially given vaccine hesitancy in some families. Clinicians might use a sleep apnoea diagnosis as a prompt to discuss immunisation during routine check-ups. Dr Gileles-Hillel added: “Framing OSA as a ‘risk marker’ for increased chances of respiratory infections and severe disease could help overcome vaccine hesitancy.”
The study also considered the pandemic’s influence on testing habits. Even in pre-Covid years, the flu risk remained higher for these children, ruling out changes in medical practices as the sole explanation. This consistency strengthens the case for viewing sleep apnoea as a key risk factor in paediatric respiratory health.
While absolute infection rates were low overall, the relative increase is notable for vulnerable groups. Families dealing with childhood sleep apnoea should consult paediatricians about monitoring symptoms and boosting immunity. Early intervention in sleep issues could still offer broader benefits, even if infection risks linger.