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Association Between Seasonal Factors and Severity of Obstructive Sleep Apnea-Hypopnea Syndrome in Children
Xueyun Xu1, Yanyu He1, Yuting Jiang1
1Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
Insights
Seasonal factors impact childhood obstructive sleep apnea-hypopnea syndrome (OSAHS) severity. Severe OSAHS and respiratory events are more frequent in winter and spring, particularly in young children.
Area of Science:
- Pediatric Respiratory Medicine
- Sleep Science
- Environmental Health
Background:
- Limited data exist on seasonal influences on childhood obstructive sleep apnea-hypopnea syndrome (OSAHS) in China.
- Investigating seasonal effects on OSAHS severity is crucial for understanding pediatric sleep disorders.
Purpose of the Study:
- To examine the correlation between seasonal variations and the severity of obstructive sleep apnea-hypopnea syndrome (OSAHS) in children.
- To identify specific seasonal patterns in OSAHS prevalence and associated respiratory events.
Main Methods:
- Children aged 2-16 with suspected OSAHS underwent full-night polysomnography (PSG).
- Data from December 2016 to February 2022 were analyzed for seasonal correlations with PSG findings.
- Prevalence of conditions like tonsillar hypertrophy, adenoid hypertrophy, rhinitis/sinusitis, and asthma were assessed seasonally.
Main Results:
- Severe OSAHS was diagnosed more frequently in winter (30.2%) compared to summer (24.6%).
- Increased respiratory events, including higher respiratory arousal and REM-apnea indices, were observed in winter and spring.
- Higher proportions of rhinitis/sinusitis and tonsillar hypertrophy occurred in spring, while adenoid hypertrophy was more prevalent in winter.
Conclusions:
- Seasonal factors, particularly winter, are associated with increased severity and respiratory events in pediatric OSAHS.
- Younger children (≤6 years) showed heightened susceptibility to seasonal variations in respiratory events.
- Findings suggest a notable impact of seasons on the manifestation and severity of childhood OSAHS.
Background:
Limited data are available on the relationship between seasonal factors and obstructive sleep apnea-hypopnea syndrome (OSAHS) in China. The aim of this study was to investigate the effects of seasonal factors on the severity of OSAHS in children.
Methods:
Children 2.0 to 16 years old presenting with snoring and/or mouth breathing, suspected of having OSAHS, and admitted to the Department of Respiratory Medicine of Children's Hospital of Soochow University from December 2016 to February 2022 were enrolled in this study. The severity of OSAHS was determined by full-night polysomnography (PSG) in the sleep laboratory. The correlation between seasonal factors and PSG monitoring results was analyzed.
Results:
Of the 589 included patients, 301 cases (51.1%) were diagnosed with OSAHS. In the OSAHS group, 77 cases (25.6%) were detected in spring, 74 cases (24.6%) were detected in summer, 59 cases (19.6%) were detected in autumn, and 91 cases (30.2%) were detected in winter. There were 238 cases (79.1%) of tonsillitis hypertrophy, 276 cases (91.7%) of adenoid hypertrophy, 215 cases (71.4%) of rhinitis/sinusitis, and 36 cases (12.0%) of asthma. The proportion of rhinitis/sinusitis and tonsillar hypertrophy in spring was higher than that in summer (P = .015 and P = .036, respectively), and the proportion of adenoid hypertrophy in winter was higher than that in summer (P = .024). The diagnostic rate of severe OSAHS in winter was higher than that in summer (χ2 = 7.053, P = .008). The respiratory arousal index in winter was higher than that in summer (H = -39.297, P = .018), and the spontaneous arousal index in spring was higher than that in autumn (H = 44.059, P = .020). It was found that the rapid eye movement (REM)-apnea index (AI) in spring and winter was higher than that in summer (H = 52.292, -52.554; all P < .05). The comparison of PSG results of children with OSAHS ≤6 years old in different seasons showed that REM-AI in winter was higher than that in summer (H = 8.570, P < .05).
Conclusion:
Severe OSAHS is more common in winter. Respiratory events are increased in spring and winter, mainly in children ≤6 years old. Seasonal factors may have a certain impact on OSAHS.
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