Gender dimorphism in pediatric OSA: Is it for real?

Area of Science:

• Pediatric Sleep Medicine
• Epidemiology
• Child Health

Background:

• Obstructive sleep apnea (OSA) shows higher prevalence in adult men than women.
• Evidence for gender-based prevalence differences in pediatric OSA is less conclusive.
• Social, cultural, and physiological factors may influence OSA manifestation and reporting in children.

Purpose of the Study:

• To review evidence on gender-based differences in pediatric OSA prevalence.
• To identify potential factors contributing to observed gender-related disparities in childhood OSA.
• To clarify the role of puberty and obesity in gender differences in pediatric OSA.

Main Methods:

• Systematic literature review of epidemiologic studies on pediatric OSA.
• Analysis of factors potentially modulating gender-based symptom reporting (e.g., snoring).
• Examination of hormonal influences (e.g., testosterone) and comorbidities (e.g., obesity).

Main Results:

• Gender-based OSA prevalence differences are unclear in pre-pubertal children.
• Differences may emerge in adolescents, particularly with co-occurring obesity.
• Increased OSA susceptibility is not evident in pre-pubertal boys versus girls, except in specific cases like obese adolescents or girls with high testosterone.

Conclusions:

• Gender-based differences in pediatric OSA prevalence are not well-established, especially in pre-pubertal children.
• Social, cultural, and physiological factors likely interact, influencing OSA presentation in children.
• Future research should explore gender-related hormonal changes as potential modulators of childhood OSA.