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Published on: December 6, 2016
Is obstructive sleep apnea syndrome in children season dependent?
Zev Frimer1, Shmuel Goldberg1, Leon Joseph1
1Pediatric Pulmonary Unit, Shaare Zedek Medical Center, School of Medicine, affiliated with The Hebrew University school of medicine, Jerusalem, Israel.
Insights
Seasonal variations do not impact the diagnosis rate of obstructive sleep apnea (OSA) in children. Re-testing children for OSA in different seasons is unlikely to change diagnosis outcomes and may delay necessary surgical interventions.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Medicine
- Clinical Diagnostics
Background:
- Obstructive sleep apnea (OSA) in children is commonly caused by enlarged tonsils/adenoids.
- Upper respiratory infections and allergen exposure, which vary seasonally, influence tonsil and adenoid size.
- Seasonal fluctuations in environmental factors suggest a potential link to OSA diagnosis rates.
Purpose of the Study:
- To investigate if the season of polysomnography testing affects the prevalence of OSA in pediatric patients.
- To determine if seasonal changes influence the diagnosis rates of obstructive sleep apnea in children.
Main Methods:
- Retrospective analysis of polysomnography (PSG) data from 296 children (ages 0-12) suspected of having OSA.
- Comparison of the Obstructive Apnea Hypopnea Index (OAHI) across different seasons (winter, spring, summer, fall).
- Evaluation of seasonal variations in the rates of mild, moderate, and severe OSA diagnoses.
Main Results:
- No significant difference was found in the mean OAHI values among the four seasons.
- Seasonal analysis revealed no significant variations in the diagnosis rates for moderate or severe OSA.
- A slight increase in mild OSA diagnoses was observed during the summer months compared to other seasons.
Conclusions:
- The season in which polysomnography is performed does not appear to influence the diagnosis of significant obstructive sleep apnea in children.
- Re-evaluating pediatric OSA patients in different seasons is unlikely to yield different diagnostic results.
- Delaying surgical intervention due to seasonal re-testing is not supported by these findings.
Introduction:
The most common cause of obstructive sleep apnea (OSA) in children is an enlargement of tonsils and/or adenoids. Previous studies have shown that the size of adenoids and tonsils is influenced by upper respiratory tract infections and exposure to allergens. The rate of exposure to bacteria, viruses, and allergens fluctuates from season to season. Therefore, we hypothesized that the rate of polysomnograms positive for OSA may vary according to season.
Objective:
The objective of this study is to determine whether the prevalence of OSA in children, as determined by polysomnography, is affected by the season during which the study was performed.
Methods:
We retrospectively reviewed polysomnography tests of 296 children, ages 0-12 years, referred for suspected OSA. We compared the Obstructive Apnea Hypopnea Index (OAHI) between the seasons and the rates of abnormal tests in each season according to the degree of severity.
Results:
The mean OAHI did not significantly differ among the seasons (winter, 3.0 ± 5.0; spring, 3.0 ± 4.9; summer, 4.0 ± 6.3; fall, 3.4 ± 5.7, p = 0.183). When dividing the OAHI by levels of severity, no seasonality was found in moderate (winter, 13.8 %; spring, 6.7 %; summer, 11.7 %; fall, 14.1 %, p = NS) and severe OSA (winter, 8.8 %; spring, 11.2 %; summer, 10 %; fall, 7.8 %, p = NS). There was a small increase in the frequency of mild OSA diagnoses in the summer compared to the other seasons.
Conclusion:
In this study, season does not appear to affect the rate of diagnosis of significant OSA in children. Re-evaluation during a different season is unlikely to provide different results and may postpone surgery unnecessarily.
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