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Association between ankyloglossia and pediatric obstructive sleep apnea: A retrospective cohort study using a global
Carlos O'Connor-Reina1, Prof David Gozal2, Maria Teresa Garcia Iriarte3
1Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680, Marbella, Spain; Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, Palmones, Spain.
Insights
Children diagnosed with ankyloglossia have a higher and earlier risk of developing obstructive sleep apnea (OSA). Frenotomy did not appear to reduce this risk in the study. Further research is needed.
Area of Science:
- Pediatric Medicine
- Otolaryngology
- Sleep Medicine
Background:
- Pediatric obstructive sleep apnea (OSA) affects millions of children globally.
- While obesity and adenotonsillar hypertrophy are known risk factors, the link between ankyloglossia and OSA is not well understood.
Purpose of the Study:
- To investigate the association between ankyloglossia diagnosis and the risk of developing pediatric obstructive sleep apnea (OSA).
Main Methods:
- A retrospective cohort study analyzed data from 3,535,879 pediatric patients.
- Propensity score matching was used to control for confounding factors.
- Kaplan-Meier survival analysis assessed OSA-free survival.
Main Results:
- Children with ankyloglossia had a significantly higher rate of OSA diagnosis (6.1% vs. 4.0%).
- OSA was diagnosed at an earlier age in children with ankyloglossia.
- Frenotomy intervention did not show a significant impact on OSA survival probability.
Conclusions:
- Ankyloglossia diagnosis is linked to an increased and earlier onset of pediatric OSA.
- The current dataset does not support a therapeutic role for frenotomy in reducing OSA risk.
- Further prospective studies are warranted to explore the relationship and potential interventions.
Objective:
Pediatric obstructive sleep apnea (OSA) affects an estimated 1-3 % of children, corresponding to over 40 million cases globally. While obesity and adenotonsillar hypertrophy are well-established pediatric risk factors, the potential role of ankyloglossia remains underexplored. We evaluated whether a diagnosis of ankyloglossia is associated with an increased risk of developing OSA in children.
Methods:
Retrospective cohort study of 3,535,879 pediatric patients from the TriNetX Global Collaborative Network (143 healthcare organizations). Two cohorts were defined based on the presence or absence of an ankyloglossia diagnosis and the subsequent development of OSA over a follow-up period of up to 10 years. Propensity score matching controlled for confounders. Kaplan-Meier survival analysis and log-rank testing assessed OSA-free survival.
Results:
Among the 37,640 children who developed OSA during follow-up (62.2 % male; mean age 2.8 ± 3.6 years), those in the ankyloglossia group were diagnosed at an earlier age (median 1525 vs. 1877 days). The rate of OSA diagnosis was higher in the ankyloglossia group: 6.1 % vs. 4.0 % (risk difference 2.1 %, 95 % CI: 1.8-2.4; RR: 1.53; OR: 1.56; P < 0.001) These values reflect outcomes from the propensity score-matched cohorts. Frenotomy did not significantly impact OSA survival probability.
Conclusion:
The diagnosis of ankyloglossia is associated with increased and earlier pediatric OSA risk. Frenotomy, as captured in this dataset, was not associated with a lower risk. These findings do not support or exclude a therapeutic role for frenotomy and highlight the need for further prospective research.
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