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Published on: December 6, 2016
Morbidity and mortality from obstructive sleep apnea in children and their parents: a controlled national study
Poul Jennum1, Nanette Debes2, Rikke Ibsen3
1Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Insights
Children with obstructive sleep apnea (OSA) experience significant pre-diagnostic health issues and increased mortality. Parental OSA also shows a strong familial link, suggesting shared risk factors for childhood OSA.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Genetics and Family Studies
Background:
- Childhood obstructive sleep apnea (cOSA) is linked to severe health problems and mortality.
- Limited data exists on pre-diagnostic health issues in children with cOSA and their parents.
Purpose of the Study:
- To investigate pre-diagnostic morbidities and mortality in children diagnosed with OSA.
- To examine parental comorbidity and the influence of parental OSA (pOSA) on cOSA.
Main Methods:
- A cohort of 2821 children (3-19 years) diagnosed with OSA was identified from the Danish National Patient Registry.
- 9901 control subjects were matched by age, gender, and socioeconomic status.
- Pre-diagnostic morbidities, mortality, and parental OSA were analyzed.
Main Results:
- Children with cOSA exhibited significantly higher morbidity across all WHO disease classes up to 3 years pre-diagnosis, particularly in endocrine, neurological, and respiratory systems.
- Five-year mortality was substantially higher in cOSA patients (18/10,000) compared to controls (2/10,000), with a hazard ratio of 3.8.
- Parental OSA shared similar comorbidity patterns with their children, and a strong familial association was observed (OR 2.3 for fathers, 8.7 for mothers).
Conclusions:
- Children with OSA face significant pre-diagnostic health burdens and increased mortality.
- OSA demonstrates a strong familial risk, with shared comorbidities between parents and children.
- These findings highlight the systemic impact of cOSA and the importance of family history.
Background:
Childhood obstructive sleep apnea (cOSA) is associated with increased morbidity and mortality, but little is known about its pre-diagnostic morbidity or that of parents of children with OSA. We aim to study pre-diagnostic morbidities, mortality, and parental comorbidity, including the effect of parental OSA (pOSA) on cOSA.
Methods:
2821 patients with OSA aged 3-19 years with a diagnosis of OSA were identified from the Danish National Patient Registry. For each patient, we randomly selected four citizens matched by age, gender, and socioeconomic status, thereby providing 9901 control subjects.
Results:
cOSA had greater morbidity at least 3 years before their diagnosis in all WHO 21 disease classes. This was most pronounced for endocrine and metabolic (OR: 3.2; 95 % CI: 2.6-4.0), neurological (OR: 5.4; 95 % CI: 4.1-7.2) and respiratory (OR: 6.7; 95 % CI: 6.0-7.4) diseases. cOSA was strongly correlated with later comorbidities in all disease domains. Five-year mortality was 18 per 10,000 for patients and 2 per 10,000 for controls. The hazard ratio for cases compared with controls was 3.8 (95 % CI: 1.7-8.4). All associations persisted when those with congenital disorders were excluded from the analyses. pOSA comorbidities showed a similar disease pattern to that of children. pOSA and cOSA are strongly associated, with a OSA odds ratios for parents compared to control parents of 2.3 (95 % CI, 1.6-3.3) for fathers and 8.7 (95 % CI, 3.6-21.2) for mothers.
Conclusions:
Children with OSA have significant morbidities and cOSA is associated with significant mortality, as is also found in the parental population. There is a strong familial risk for cOSA and co-existence of comorbidities in all domains.
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