Elevated morbidity and health care use in children with obstructive sleep apnea syndrome
Ariel Tarasiuk1, Sari Greenberg-Dotan, Tzahit Simon-Tuval
1Department of Physiology, Faculty of Health Sciences, P.O. Box 653, Ben-Gurion University of the Negev, Beer-Sheva, Israel. tarasiuk@bgu.ac.il
Insights
Children diagnosed with obstructive sleep apnea syndrome (OSAS) exhibit increased healthcare utilization and respiratory-related illnesses from their first year of life. Early identification of OSAS in children is crucial for managing associated health issues.
Area of Science:
- Pediatric Health
- Sleep Medicine
- Morbidity Studies
Background:
- Healthcare utilization is a key indicator of childhood morbidity.
- Increased healthcare use is observed in preschool children a year prior to obstructive sleep apnea syndrome (OSAS) diagnosis.
- The age at which OSAS-related morbidity manifests remains unclear.
Purpose of the Study:
- To investigate morbidity and healthcare use in children diagnosed with OSAS, beginning from their first year of life.
- To establish the early signs and patterns of health issues associated with OSAS in pediatric populations.
- To correlate healthcare resource utilization with the onset of OSAS in early childhood.
Main Methods:
- A case-control study involving 156 children aged 3-5 years diagnosed with OSAS and matched healthy controls.
- Data collection spanned from the first year of life up to the OSAS diagnosis date.
- Health records and computerized databases from Clalit Health Care Services were utilized to track diagnoses and healthcare utilization.
Main Results:
- Children with OSAS showed a 40% increase in hospital visits and a 20% rise in repeated visits compared to controls.
- Higher consumption of anti-infective and respiratory drugs was noted in the OSAS group (p < 0.0001).
- Referrals to otolaryngology and pediatric pulmonology specialists were significantly higher from Year 1, peaking in Year 4 (OR, 9.4).
Conclusions:
- Children with OSAS demonstrate elevated healthcare use, primarily for respiratory conditions, starting from their first year of life.
- Healthcare providers should recognize the early signs of increased morbidity in infants and young children who later receive an OSAS diagnosis.
- This highlights the importance of early detection and intervention for OSAS to mitigate long-term health consequences.
Rationale:
Health care use, a reliable measure of morbidity, is noticeably higher 1 yr before obstructive sleep apnea syndrome (OSAS) diagnosis in preschool children. It is not clear at what age OSAS-related morbidity becomes expressed.
Objective:
To explore morbidity and health care use among children with OSAS starting from first year of life.
Methods:
Case-control study, starting from the first year of life to date of OSAS diagnosis, among 156 patients (age range, 3-5 yr) and their pair-matched healthy control subjects, by age, sex, primary care physician, and geographic location.
Measurements:
Patients with OSAS underwent nocturnal polysomnography studies. Medical records during hospital visits were reviewed for diagnosis. Variables of health care use were obtained from computerized databases of Clalit Health Care Services, the largest health maintenance organization in Israel.
Main Results:
From the first year of life to date of OSAS diagnosis, children with OSAS had 40% more (p = 0.048) hospital visits, 20% more repeated (two or more) visits (p < 0.0001), and higher consumption of antiinfective and respiratory system drugs (p < 0.0001). Referrals of children with OSAS to otolaryngology surgeons and pediatric pulmonologists were higher from Year 1 (p < 0.0001) to date of OSAS diagnosis, especially in Year 4 (odds ratio, 9.4; 95% confidence interval, 4.2-21.1). The 215% elevation (p < 0.0001) in health care use of the OSAS group was due mainly to higher occurrence of respiratory tract morbidity (p < 0.0001).
Conclusions:
Practitioners should be aware that starting in Year 1 until date of diagnosis, children with OSAS have higher health care use, mostly related to respiratory diseases.
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