Related Experiment Video
Updated: Jun 24, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Socioeconomic determinants of moderate and severe obstructive sleep apnea in children: A pre and post COVID analysis
1University of Connecticut School of Medicine, Department of Surgery, Division of Otolaryngology Head and Neck Surgery, 263 Farmington Avenue, Farmington, CT, 06030, USA.
Insights
The COVID-19 pandemic significantly increased the time to diagnosis for pediatric obstructive sleep apnea (OSA), impacting all socioeconomic groups. This highlights existing healthcare disparities and the need for increased support for children
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Public Health
Background:
- COVID-19 exacerbated healthcare access issues for minority groups, potentially delaying pediatric obstructive sleep apnea (OSA) diagnosis and management.
- Socioeconomic status (SES) is a known determinant of healthcare access in pediatric otolaryngology and a potential risk factor for OSA.
Purpose of the Study:
- To assess the impact of COVID-19 on time to diagnosis (TTD) and time to treatment (TTT) for moderate to severe pediatric OSA.
- To analyze how socioeconomic status, race, and demographics influence TTD and TTT in pediatric OSA patients.
Main Methods:
- Retrospective chart review of 120 children (3-17 years) with moderate to severe OSA confirmed by polysomnography (PSG).
- Study included 60 children pre-COVID (Feb 2018-Feb 2020) and 60 post-COVID onset (Mar 2020-Mar 2022).
- Data collected from a pediatric teaching hospital and tertiary referral center.
Main Results:
- Overall TTD for pediatric OSA increased from 53.7 to 103 days post-COVID (p=0.00).
- Significant increases in TTD were observed across racial and socioeconomic groups, including white children (42.5 to 151.9 days) and those with high SES (38 to 142.7 days).
- Time to treatment (TTT) did not show significant changes.
Conclusions:
- The COVID-19 pandemic disproportionately affected the time to diagnosis for pediatric OSA, particularly in advantaged socioeconomic groups.
- Findings underscore the vulnerability of various populations to healthcare disparities exacerbated by the pandemic.
- Recommendations include increased funding and support for all children's healthcare, with continued focus on lower SES populations.
Introduction:
COVID-19 has disproportionately affected healthcare access of certain minority groups, and thus could contribute to delay in timely evaluation and management of pediatric obstructive sleep apnea (OSA). Socioeconomic status (SES) is known to affect healthcare access in pediatric otolaryngology and may also be a risk factor for OSA and its associated co-morbidities.
Objectives:
Our primary objective is to determine the impact of COVID-19 on time to diagnosis (TTD) and time to treatment (TTT) of polysomnography (PSG)-proven moderate to severe pediatric OSA in different socioeconomic classes. Secondary objectives include determining the impact of racial and demographic factors on TTD and TTT.
Methods:
This is a retrospective chart review of 120 children; 60 children pre-COVID (February 2018 to February 2020), and 60 children post-COVID onset (March 2020 to March 2022). This study was performed at a pediatric teaching hospital and tertiary referral center, and involved children aged 3-17 years old with outpatient PSG-proven moderate to severe OSA. Approval was obtained from our hospital's institutional review board (IRB).
Results:
There were a total of 120 children, 60 in each group. The average age was 9.5 years old; females constituted 41.6 % of the sample. TTD increased from 53.7 days pre-covid to 103 days post-COVID onset in all children (p = 0.00), 42.5 days-151.9 days in white children (p = 0.00), 38 days-142.7 days in children with high SES (p = 0.00), 32.1 days-146.5 days in children with private insurance (p = 0.00), and 65.7 days-105.8 days in children with public insurance (p = 0.04). TTT did not change significantly.
Conclusion:
Our results show that TTD of OSA and obesity in advantaged groups were affected to a greater degree than disadvantaged groups. This suggests children of all socioeconomic groups are susceptible to healthcare disparities and the COVID-19 pandemic has uncovered the vulnerability of such populations. Policymakers should consider providing more funding and support for all children, including continued funding for those with lower SES.
More Related Videos
Related Concept Videos
01:21Sleep Apnea
The condition is more prevalent among...
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...
01:26COPD: Management Using Bronchodilators and Corticosteroids