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Analysis of the Risk Factors Associated With Obstructive Sleep Apnea Syndrome in Chinese Children
Ling Xiao1,2,3,4,5, Shuping Su1,2,3,4,5, Jia Liang1,2,3,4,5
1Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China.
Insights
Pediatric obstructive sleep apnea syndrome (OSAS) is linked to adenoid and tonsil hypertrophy, which increase incidence but not severity. Other factors include obesity and family history.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Otolaryngology
Background:
- Obstructive sleep apnea syndrome (OSAS) is a prevalent condition in children.
- Identifying risk factors for pediatric OSAS is crucial for timely diagnosis and intervention.
Purpose of the Study:
- To explore risk factors associated with the incidence and severity of pediatric OSAS.
- To analyze factors differentiating OSAS from primary snoring (PS) in children.
Main Methods:
- A study involving 1,550 pediatric patients presenting with snoring or open-mouth breathing.
- Utilized questionnaires, physical examinations, and polysomnography (PSG).
- Employed univariate, multivariate logistic regression, and correlation analyses to identify risk factors and their association with OSAS and its severity.
Main Results:
- Obesity, family passive smoking, snoring history, allergic rhinitis, asthma, adenoid hypertrophy, and tonsil hypertrophy were associated with pediatric OSAS in univariate analysis.
- Adenoid hypertrophy (OR: 1.835) and tonsil hypertrophy (OR: 1.283) were independently associated with the risk of pediatric OSAS.
- OSAS incidence increased with adenoid and tonsil size, but severity did not correlate with tonsil or adenoid size.
Conclusions:
- Adenoid and tonsil hypertrophy are significant independent risk factors for pediatric OSAS.
- Increased adenoid and tonsil size correlate with higher OSAS incidence.
- The severity of pediatric OSAS is not directly proportional to the size of tonsils or adenoids.
Objective:
The present study was developed to explore risk factors related to the incidence and severity of obstructive sleep apnea syndrome (OSAS) in children.
Methods:
The present study enrolled pediatric patients who admitted to our department for snoring and/or open-mouth breathing. All children completed a questionnaire and underwent physical examination and polysomnography (PSG). The cases were separated into OSAS and primary snoring (PS) groups. Factors associated with these two groups were analyzed, with risk factors significantly associated with OSAS then being identified through logistic regression analyses. OSAS was further subdivided into mild, moderate, and severe subgroups, with correlations between risk factors and OSAS severity then being analyzed.
Results:
In total, 1,550 children were included in the present study, of which 852 and 698 were enrolled in the OSAS and PS groups. In univariate analyses, obesity, family passive smoking, a family history of snoring, allergic rhinitis, asthma, adenoid hypertrophy, and tonsil hypertrophy were all related to pediatric OSAS (P < 0.05). In a multivariate logistic regression analysis, adenoid hypertrophy (OR:1.835, 95% CI: 1.482-2.271) and tonsil hypertrophy (OR:1.283, 95% CI:1.014-1.622) were independently associated with the risk of pediatric OSAS (P < 0.05). Stratification analyses revealed that OSAS incidence increased in a stepwise manner with increases in adenoid and tonsil grading (P < 0.01). Correlation analyses revealed that adenoid hypertrophy and tonsilar hypertrophy were not significantly associated with OSAS severity (r = 0.253, 0.069, respectively, P < 0.05), and tonsil and adenoid size were no correlation with obstructive apnea-hypopnea index (OAHI) (r = 0.237,0.193, respectively, P < 0.001).
Conclusion:
Obesity, family passive smoking, a family history of snoring, allergic rhinitis, asthma, tonsil hypertrophy, and adenoid hypertrophy may be potential risk factors for pediatric OSAS. Adenoid hypertrophy and tonsil hypertrophy were independently related to the risk of pediatric OSAS, with OSAS incidence increasing with the size of the adenoid and tonsil, while the severity of OSAS is not parallel related to the adenoid or tonsil size.
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