Assessment of neighborhood-level disadvantage and pediatric obstructive sleep apnea severity

Area of Science:

• Pediatric Sleep Medicine
• Public Health
• Socioeconomic Determinants of Health

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition in children, impacting their health and development.
• Socioeconomic factors may influence OSA prevalence and severity, but their independent role requires further investigation.
• Understanding neighborhood-level influences is crucial for addressing health disparities in pediatric OSA.

Purpose of the Study:

• To investigate the association between neighborhood socioeconomic disadvantage and severe obstructive sleep apnea (OSA) in children.
• To determine if area-level deprivation predicts the presence of severe OSA or residual OSA after adenotonsillectomy.

Main Methods:

• Retrospective case-control study of 249 children undergoing adenotonsillectomy with pre-operative polysomnography.
• Children were categorized into socioeconomically disadvantaged and advantaged groups using the Area Deprivation Index (ADI).
• Apnea-Hypopnea Index (AHI) and severe OSA presence were primary outcomes; residual moderate or greater OSA post-surgery was a secondary outcome.

Main Results:

• No significant difference in AHI or severe OSA was observed between socioeconomically disadvantaged and advantaged groups.
• Severe OSA was independently associated with obesity (OR=3.13, 95% CI=1.83-5.34).
• Residual moderate or greater OSA after surgery was associated with older age (OR=1.20, 95% CI=1.05-1.38).

Conclusions:

• Neighborhood socioeconomic disadvantage, as measured by ADI, was not significantly associated with severe or residual OSA in this pediatric cohort.
• While neighborhood disadvantage may contribute to OSA comorbidities, it did not emerge as an independent risk factor for severe OSA in this study.
• Obesity and older age were identified as significant factors associated with OSA severity and persistence, respectively.