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Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems
S Redline1, P V Tishler, M Schluchter
1Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Childrens Hospital, Cleveland, Ohio, USA.
Insights
Obesity and African-American race are key risk factors for sleep-disordered breathing (SDB) in children. Respiratory issues like sinus problems and wheezing also independently predict SDB risk.
Area of Science:
- Pediatrics
- Sleep Medicine
- Epidemiology
Background:
- Sleep-disordered breathing (SDB) affects children and adolescents.
- Identifying risk factors is crucial for early intervention and management.
Purpose of the Study:
- To investigate risk factors for SDB in pediatric populations.
- Quantify the association of obesity, race, and respiratory problems with SDB.
Main Methods:
- Recruited 399 children and adolescents (2-18 years) from families with and without a sleep apnea proband.
- Assessed SDB using home overnight multichannel monitoring.
- Defined SDB based on an apnea-hypopnea index >/= 10.
Main Results:
- Obesity (OR, 4.59) and African-American race (OR, 3.49) were significantly associated with moderate SDB.
- Sinus problems and persistent wheeze independently predicted SDB after adjusting for other factors.
- Risk in African Americans was independent of obesity or respiratory issues.
Conclusions:
- Obesity, African-American race, and respiratory problems are significant risk factors for pediatric SDB.
- These findings highlight the need for targeted screening and management strategies.
- Further research into the specific mechanisms underlying SDB in diverse populations is warranted.
Abstract:
This study examined risk factors for sleep-disordered breathing (SDB) in children and adolescents; specifically, quantifying risk associated with obesity, race, and upper and lower respiratory problems. Subjects were participants in a genetic-epidemiologic study of SDB and included 399 children and adolescents 2 to 18 yr of age, recruited as members of families with a member (a proband) with known sleep apnea (31 index families) or as members of neighborhood control families (30 families). SDB was assessed with home overnight multichannel monitoring and SDB was defined based on an apneahypopnea index >/= 10 (moderately affected) or < 5 (unaffected). SDB of moderate level was significantly associated with obesity (odds ratio, 4.59; 95% confidence interval [CI], 1.58 to 13.33) and African-American race (odds ratio, 3.49; 95% CI, 1.56 to 8.32) but not with sex or age. After adjusting for obesity, proband sampling, race and familial clustering, sinus problems and persistent wheeze each independently (of the other) predicted SDB. These data suggest the importance of upper and lower respiratory problems and obesity as risk factors for SDB in children and adolescents. Increased risk in African Americans appears to be independent of the effects of obesity or respiratory problems.