Tobacco smoke exposure as a risk factor for obstructive sleep apnea in children

Pediatr Int. 2020 Jul;62(7):840-847. doi: 10.1111/ped.14191.

Abstract

Background: The most common respiratory disturbance in sleeping children is obstructive sleep apnea syndrome (OSAS). Passive smoking is one of factors predisposing to OSAS. The aim of this study was to determine the correlations between exposure to tobacco smoke (passive smoking) and development of respiratory disorders in children during sleep.

Methods: One hundred and sixty school-aged children (6-18 years) were included in the study. The inclusion criterion was exposure to tobacco smoke at home (n = 90). The control group were school-aged children who had had no contact with tobacco smoke at home (n = 70). Exclusion criteria were obesity and children with impaired patency of the nose. Each child had a polygraphic examination performed at home. The children and their parents completed a questionnaire to assess the level of child's exposure to tobacco smoke. The study ran from December 15, 2012 to February 26, 2016.

Results: OSAS was observed in 12% of children with an apnea-hypopnea index >1.5 (<13 years of age) and an apnea-hypopnea index >5 (for children >13 years), and with diurnal and nocturnal symptoms. Children exposed to tobacco smoke presented more apnea-hypopnea events (n = 17) than the control group (n = 3; P < 0.001). In the group exposed to tobacco smoke the following issues were noted: concentration problems (38.9%), tiredness/lethargy (46.7%), and irritability/hyperactivity (36.7%). No statistically significant differences were found in waking up, snoring, or sleep apnea.

Conclusions: OSAS occurs more often in children exposed to tobacco smoke and these children demonstrate concentration problems, tiredness, and irritability/hyperactivity to a greater extent than control group.

Keywords: adolescent; apnea; obstructive sleep apnea; polysomnography; tobacco.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Hyperkinesis / epidemiology
  • Irritable Mood
  • Lethargy / epidemiology
  • Male
  • Obesity / epidemiology
  • Polysomnography / methods
  • Risk Factors
  • Sleep
  • Sleep Apnea Syndromes / epidemiology
  • Sleep Apnea, Obstructive / epidemiology*
  • Sleep Apnea, Obstructive / etiology
  • Snoring / epidemiology
  • Surveys and Questionnaires
  • Tobacco Smoke Pollution / adverse effects*

Substances

  • Tobacco Smoke Pollution