Integrative traditional Chinese medicine treatment for children with obstructive sleep apnea

Wan-Yu Lai; Chang-Ching Wei; Chien-Heng Lin; Liang-Wen Hang; Ying-Hsiu Shih; Fen-Wei Huang; Hung-Rong Yen

doi:10.1016/j.jtcme.2023.08.002

Integrative traditional Chinese medicine treatment for children with obstructive sleep apnea

J Tradit Complement Med. 2023 Aug 7;14(1):109-120. doi: 10.1016/j.jtcme.2023.08.002. eCollection 2024 Jan.

Authors

Wan-Yu Lai^{1

2}, Chang-Ching Wei^{3

4}, Chien-Heng Lin^{3

4}, Liang-Wen Hang⁵, Ying-Hsiu Shih⁶, Fen-Wei Huang⁷, Hung-Rong Yen^{1

2

8

9

10}

Affiliations

¹ Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
² School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
³ Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan.
⁴ School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
⁵ Sleep Medicine Center, China Medical University Hospital, Taichung, Taiwan.
⁶ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁷ Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
⁸ Chinese Medicine Research Center, China Medical University, Taichung, Taiwan.
⁹ Research Center for Traditional Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
¹⁰ Department of Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan.

Abstract

Purpose: Obstructive sleep apnea (OSA) is a chronic disease that affects 1%-6% of children. Our study aims to explore the effectiveness and clinical characteristics of integrative Traditional Chinese Medicine (ITCM) for pediatric OSA.

Materials and methods: In this retrospective cohort study, we assessed differences of polysomnography (PSG) parameters and clinical characteristics between 2009 and 2020. Children <12 years old diagnosed with OSA (n = 508) were included and were categorized into ITCM cohort, western medicine (WM) cohort ,and surgery cohort. Outcomes were apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and body mass index (BMI).

Results: There were 56 (11%), 324 (63.8%), and 128 (25.2%) patients in the ITCM, WM, and surgery cohorts. Among 17, 26, and 33 patients in the ITCM, WM, and surgery cohorts underwent follow-up PSG studies, respectively. In the ITCM follow-up cohort, AHI were significantly reduced (9.59 to 5.71, p < 0.05). BMI significantly increased in the WM follow-up cohort (19.46 to 20.50, p < 0.05) and the surgery follow-up cohort (18.04 to 18.85, p < 0.01). Comparing ITCM to WM cohort, a significant difference was found between the changes in RDI (ITCM: -6.78, WM: 0.51, p < 0.05) after treatment. Among ITCM follow-up cohort, the most prescribed TCM formula was Forsythia and Laminaria Combination. The most prescribed TCM herb was Ephedrae Herba.

Conclusions: ITCM therapy can significantly reduce RDI and control BMI. We identified potential TCM treatments for pediatric OSA. Further study of the pharmacological mechanisms and clinical efficacy is warranted.

Keywords: Children; Ephedrae Herba; Forsythia and Laminaria combination; Obstructive sleep apnea;; Traditional Chinese medicine.