Celiac Kids with Obstructive Sleep Apnea Improve on a Gluten-Free Diet

Celiac.com 04/09/2018 - Children with obstructive sleep apnea (OSA) often have enlarged tonsils and adenoids. Additionally, lymphatic hyperplasia, an increase in the number of normal cells that are contained in lymph nodes, is common to both OSA and celiac disease. Lymphoid hyperplasia is usually due to an infection with bacteria, viruses, or other types of germs and is part of the body's reaction to the infection.  A team of researchers recently set out to investigate the effect of a gluten-free diet on OSA symptoms in children with celiac disease.

The research team included A Yerushalmy-Feler, R Tauman, A Derowe, E Averbuch, A Ben-Tov, Y Weintraub, D Weiner, A Amir, H Moran-Lev, and S Cohen. They are variously affiliated with the Pediatric Gastroenterology Unit, the Pediatric ENT Unit, and the Pediatric Sleep Center at "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center in Tel Aviv, Israel; and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

The team recruited children with celiac disease from ages 2-18 before the children began a gluten-free diet. As a control group, the team included children with negative celiac serology who underwent gastrointestinal endoscopies for other reasons.  All participants completed a validated OSA-related symptoms questionnaire and the pediatric sleep questionnaire (PSQ) at the start of the study, and again 6 months later. 

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The team recruited thirty-four children with celiac disease, along with twenty-four control subjects. Both groups were similar in terms of gender, body mass index or season at recruitment between the two groups.  The control group showed more OSA-related symptoms compared to the celiac group, both at recruitment and at the 6-month follow-up. Both groups showed significant improvement in PSQ scores at the 6-month follow-up, but improvement was significantly higher in the celiac group compared to the control group.

Kids with celiac disease had fewer OSA-related symptoms than control subjects, but they had much higher levels of symptom improvement once they were on a gluten-free diet. 

Overall, the data from this study suggests that a gluten-free diet provides strong improvement of OSA-related symptoms in children with celiac disease.

Source:

• BMC Pediatr. 2018 Feb 7;18(1):35. doi: 10.1186/s12887-018-1039-5.