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Published on: December 6, 2016
Seasonal variability of sleep-disordered breathing in children
David Gozal1, Ahmad Shata, Meiho Nakayama
1Department of Pediatrics and Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA. dgozal@uchicago.edu
Insights
Pediatric snoring and sleep-disordered breathing (SDB) show seasonal patterns. Snoring peaks in spring/summer, while SDB severity is highest in winter/spring, suggesting environmental influences.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Environmental Health
Background:
- Snoring and sleep-disordered breathing (SDB) are common in children.
- Allergies and viral infections are suspected contributors to SDB.
- The seasonal distribution of pediatric SDB has not been previously studied.
Purpose of the Study:
- To investigate the seasonal patterns of snoring and SDB severity in children.
- To determine if seasonal factors influence the prevalence and severity of pediatric SDB.
Main Methods:
- Retrospective analysis of data from a prospective, cross-sectional community-based study.
- Inclusion of 1,051 children with a mean age of 7 years.
- Assessment of snoring frequency/loudness and overnight sleep study data for seasonal variations.
Main Results:
- Snoring frequency and loudness were significantly higher in spring and summer.
- The mean apnea-hypopnea index (AHI) was highest in winter and spring.
- The lowest oxygen saturation (SaO2) nadir occurred in winter and spring.
Conclusions:
- Pediatric snoring and SDB severity exhibit distinct seasonal patterns.
- Snoring prevalence peaks in spring-summer, while SDB severity peaks in winter-spring.
- Seasonal viral and allergen exposure may contribute to SDB severity in children.
Introduction:
Snoring and sleep-disordered breathing (SDB) are frequent pediatric conditions. Although allergies and respiratory viruses have been pathophysiologically implicated in these conditions, their seasonal distribution has not been examined.
Methods:
The records of all children participating in a prospective, cross-sectional community-based research study that included a questionnaire on snoring frequency and loudness and an overnight sleep study were retrospectively assessed for seasonal patterns based on the day the children were evaluated.
Results:
A total of 1,051 children were included with a mean age of 7 years. There were no seasonal differences in the number of children evaluated or in their demographic characteristics. However, the odds of increased snoring frequency and loudness were significantly higher in spring and summer and lowest in fall (P < 0.001). However, the mean AHI was highest and the nadir SaO(2) was lowest in winter and spring compared to summer and fall (P < 0.001 and P < 0.03, respectively).
Conclusion:
Snoring and the severity of SDB exhibit distinct and essentially non-overlapping patterns of seasonal variation, with peaks in spring-summer for snoring and peaks in winter-spring for SDB severity. These findings suggest that both seasonal viral and allergen burdens may contribute to SDB severity and may prompt differing clinical referral patterns throughout the year.
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