Relationship between snoring and sleep disordered breathing in children

the link between snoring and Sleep Disordered Breathing (SDB) is obvious, but little is known about the relationship between the intensity of the former and the severity of the latter in children.

retrospective study of polysomnography (PSG) including snoring recordings in children without co-morbidity, except for possible asthma or obesity, and tested for suspected Obstructive Sleep Apnea Syndrome (OSAS).

We retrieved 477 PSG recordings performed in children (177 (37.1 %) females) with a median age of 8.8 years. Indexes (median [Q1; Q3]) were 154 [26; 374]/h for snore (SI), 3.0 [1.4; 5.8]/h for Obstructive Apnea-Hypopnea (OAHI), 1.5 [0.5; 4.6]/h for oxygen desaturation (ODI) and 6.9 [4.8; 10.6]/h for arousal (ArI, n = 463). The SI was significantly correlated to OAHI, ODI or ArI (ρ = 0.45, 0.41 and 0.31, respectively, all P-values <10^-5). A SI threshold of 172/h had 78 % specificity to detect the absence of OSAS, whereas a threshold of 267/h had 82 % sensitivity to detect severe OSAS. In multivariate analyses, age/ODI were negatively and BMI/OAHI were positively associated with SI (β = -13 (95 % CI: -19,-7.5; p < 0.001); -5.8 (95 % CI: -11, -0.25; p = 0.041); 28 (95 % CI: 15, 41; p < 0.001), and 16 (95 % CI: 9.7, 22; p < 0.001), respectively).

SI is related to SDB as high SI (>267/h) is in favor of severe OSAS, and low SI (≤172/h) is in favor of no OSAS. Including standardized snoring analyses in level III recordings could be an easy objective tool to characterize children's SDB phenotype.