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Age-Dependent Risk Factors in Pediatric Sleep-Disordered Breathing: A Large-Scale Cross-Sectional Study
Gintare Oboleviciene1, Viktorija Mejeryte1, Norvile Jotautaite1
1Pediatric Department, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Str. 2, LT-50103 Kaunas, Lithuania.
Insights
Approximately 15% of Lithuanian children screened positive for sleep-related breathing disorders (SRBDs). Risk factors varied by age, with attention deficit hyperactivity disorder (ADHD) being a common link across all age groups.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Public Health
Background:
- Sleep-related breathing disorders (SRBDs) are prevalent yet often undiagnosed in children.
- Untreated pediatric SRBDs can lead to significant cognitive, metabolic, and cardiovascular issues.
- Early identification and intervention are crucial for managing pediatric SRBDs.
Purpose of the Study:
- To determine the prevalence of children at risk for SRBDs in Lithuania.
- To identify and analyze risk factors associated with SRBDs across different pediatric age groups.
- To inform targeted screening and intervention strategies for pediatric SRBDs.
Main Methods:
- A cross-sectional study involving 1929 children aged 2-17 years in Lithuania.
- Parental completion of a questionnaire including demographics, health status, and the validated Lithuanian Pediatric Sleep Questionnaire (PSQ).
- Screening positive for SRBDs was defined as ≥8 (40%) positive responses on the PSQ.
Main Results:
- Overall, 14.9% of children screened positive for SRBDs.
- Prevalence varied by age: 17.5% in 7-11 years, 14.9% in 2-6 years, and 12.6% in ≥12 years.
- Key risk factors included ADHD (all ages), allergic rhinitis (preschoolers), endocrine diseases (school-aged and adolescents), adenotonsillar hypertrophy (school-aged), and obesity (adolescents).
Conclusions:
- Nearly 15% of Lithuanian children are at risk for SRBDs.
- Age-specific risk factors for SRBDs were identified, highlighting the need for tailored approaches.
- Attention deficit hyperactivity disorder (ADHD) emerged as a significant risk factor across all pediatric age groups studied.
Abstract:
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.
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