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Published on: October 2, 2019
Sleep architecture in school-aged children with primary snoring
Yin Zhu1, Chun-Ting Au1, Hugh S Lam1
1Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Insights
Primary snoring (PS) in children does not significantly alter sleep architecture in those who are prepubertal. However, pubertal adolescents with PS experience increased N1 sleep and wake after sleep onset (WASO).
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Medicine
- Child Neurology
Background:
- Primary snoring (PS) is common in school-aged children, but its impact on sleep architecture is not fully understood.
- Obstructive sleep apnea (OSA) is a concern in children with snoring, necessitating differentiation from primary snoring.
Purpose of the Study:
- To investigate the effects of primary snoring on sleep architecture in school-aged children.
- To compare sleep patterns between children with primary snoring, healthy controls, and varying degrees of obstructive sleep apnea.
Main Methods:
- Recruited 619 children aged 6-13 years from primary schools.
- Utilized parent-completed OSA screening questionnaires and overnight polysomnography (PSG).
- Classified participants into healthy controls, PS, mild OSA, and moderate to severe OSA (MS OSA) groups.
Main Results:
- No significant sleep architecture differences were found between PS and healthy controls in the overall cohort.
- Sleep-disordered breathing (SDB) severity correlated positively with NREM stage 1 (N1) sleep and negatively with slow-wave sleep (SWS).
- Pubertal adolescents with PS showed increased N1 sleep and wake after sleep onset (WASO) compared to controls.
Conclusions:
- Primary snoring does not adversely affect sleep architecture in prepubertal children.
- Pubertal adolescents with primary snoring exhibit altered sleep patterns, specifically increased N1 sleep and WASO.
Objective:
We aimed to examine if sleep architecture was altered in school-aged children with primary snoring (PS).
Methods:
Children ages 6 to 13 years from 13 primary schools were randomly recruited. A validated obstructive sleep apnea (OSA) screening questionnaire was completed by their parents. Children at high risk for OSA and a randomly chosen low-risk group were invited to undergo overnight polysomnography (PSG) and clinical examination. Participants were classified into healthy controls, PS, mild OSA, and moderate to severe OSA (MS OSA) groups for comparison.
Results:
A total of 619 participants underwent PSG (mean age, 10.0 ± 1.8 years; 396 (64.0%) boys; 524 (84.7%) prepubertal). For the cohort as a whole, there were no significant differences in measures of sleep architecture between PS and nonsnoring healthy controls. In the multiple regression model, percentage of nonrapid eye movement (NREM) stage 1 (N1) sleep had a significantly positive association, whereas percentage of slow-wave sleep (SWS) had a significantly negative association with sleep-disordered breathing (SDB) severity after controlling for age, gender, body mass index (BMI) z score, and pubertal status. In prepubertal children with PS, no significant disruption of sleep architecture was found. However, pubertal adolescent PS participants had significantly higher adjusted percentage of N1 sleep and wake after sleep onset (WASO) compared to healthy controls.
Conclusions:
PS did not exert significant adverse influences on normal sleep architecture in prepubertal school-aged children. Nevertheless, pubertal adolescents with PS had increased N1 sleep and WASO.
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