Subtypes of obstructive sleep apnea in children and related factors

Yunxiao Wu; Li Zheng; Guanqun Cui; Zhifei Xu; Xin Ni

doi:10.5664/jcsm.10124

Subtypes of obstructive sleep apnea in children and related factors

J Clin Sleep Med. 2022 Oct 1;18(10):2397-2404. doi: 10.5664/jcsm.10124.

Authors

Yunxiao Wu¹, Li Zheng², Guanqun Cui³, Zhifei Xu⁴, Xin Ni²

Affiliations

¹ Beijing Key Laboratory of Pediatric Diseases of Otolaryngology, Head, and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
² Department of Otolaryngology, Head, and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
³ Department of Respiratory Medicine, Qilu Children's Hospital of Shandong University, Jinan, China.
⁴ Department of Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Abstract

Study objectives: To investigate the prevalence of positional obstructive sleep apnea (P-OSA) and rapid eye movement-related OSA (REM-OSA) in children with OSA and identify related factors.

Methods: This was a cross-sectional study among children aged 2-12 years diagnosed with OSA using overnight polysomnography (PSG) between August 1, 2020, and July 31, 2021. Demographics, anthropometrics, PSG, and OSA-18 questionnaire data were recorded.

Results: Data from a total of 474 children were available for analysis. Children had a median age of 4.8 (4.1, 6.4) years, 66.7% were male, and 23.2% were obese. The prevalence of P-OSA was 38.2% and that of REM-OSA was 43.0%. P-OSA was correlated with age and obstructive apnea-hypopnea index (OAHI; odds ratio [OR] = 1.172, 0.947; P = .005, < 0.001, respectively), but not sex, obesity, and adenoid and tonsil size (OR = 1.265, 0.785, 0.826, 0.989; P = .258, 0.327, 0.153, 0.905, respectively). REM-OSA was correlated with age, adenoid size, tonsil size, and OAHI (OR = 0.876, 1.320, 1.387, 1.021; P = .024, 0.040, 0.001, 0.042) but not with sex and obesity (OR = 0.910, 1.281; P = .643, 0.315).

Conclusions: The prevalence of P-OSA was 38.2% and that of REM-OSA was 43.0% in children with OSA. Age was correlated with both the prevalence of P-OSA and REM-OSA, with an increasing and decreasing prevalence as children grew older, respectively. The severity of OSA was significantly associated with the prevalence of both P-OSA and REM-OSA. Adenoid and tonsil size were correlated with the prevalence of REM-OSA but not P-OSA. Obesity and sex were not associated with the prevalence of P-OSA or REM-OSA.

Citation: Wu Y, Zheng L, Cui G, Xu Z, Ni X. Subtypes of obstructive sleep apnea in children and related factors. J Clin Sleep Med. 2022;18(10):2397-2404.

Keywords: child; obstructive; sleep apnea; subtype.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Cross-Sectional Studies
Female
Humans
Male
Obesity / complications
Polysomnography
Sleep Apnea, Obstructive* / complications
Sleep, REM