Age-Dependent Risk Factors in Pediatric Sleep-Disordered Breathing: A Large-Scale Cross-Sectional Study

Background and Objectives: Sleep-related breathing disorders (SRBDs) are common but often underdiagnosed in children. Early identification is essential, as untreated pediatric SRBDs can lead to cognitive, metabolic, and cardiovascular complications. This study aimed to estimate the prevalence of children at risk for SRBDs, defined as those screening positive based on Pediatric Sleep Questionnaire (PSQ) scores, and to analyze the association with potential risk factors in the general pediatric population of Lithuania. Materials and Methods: This cross-sectional study included 1929 children aged 2-17 years. Parents completed a questionnaire covering demographics, health status, and the PSQ. A validated Lithuanian version of the PSQ was used, with ≥8 (40%) positive responses indicating suspected SRBDs. Results: Overall, 14.9% of children were suspected of having SRBDs, with the highest prevalence among those aged 7-11 years (17.5%), followed by 2-6 years (14.9%) and ≥12 years (12.6%) (p = 0.032). In preschoolers (2-6 years), the strongest predictors were attention deficit hyperactivity disorder (ADHD; p < 0.001, OR 4.456, 95% CI 1.992-9.968) and allergic rhinitis (p < 0.001, OR 2.268, 95% CI 1.433-3.591). In children aged 7-11 years, endocrine diseases showed the strongest association (p < 0.001, OR 13.366, 95% CI 2.914-61.313), followed by ADHD (p = 0.001, OR 5.693, 95% CI 1.981-16.363) and adenotonsillar hypertrophy (p < 0.001, OR 3.079, 95% CI 1.839-5.156). In adolescents (≥12 years), SRBDs were primarily associated with ADHD (p < 0.001, OR 17.513, 95% CI 9.597-31.961) and endocrine diseases (p < 0.001, OR 6.214, 95% CI 2.965-13.020), while obesity remained significant (p < 0.001, OR 3.400, 95% CI 2.106-5.489). Conclusions: Approximately 15% of Lithuanian children were at risk for SRBDs. Risk factors differed by age: adenotonsillar hypertrophy in school-aged children, allergic rhinitis in preschoolers, and obesity in adolescents, whereas ADHD was associated across age groups.