Risk factors associated with obstructive sleep apnea-hypopnea syndrome in Chinese children: A single center retrospective case-control study.

Ling Shen,Zongtong Lin,Xing Lin,Zhongjie Yang,Manlio Milanese

doi:10.1371/journal.pone.0203695

Ling Shen, Zongtong Lin + Show 3 more

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https://doi.org/10.1371/journal.pone.0203695

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Journal: PloS one	Publication Date: Sep 13, 2018
Citations: 21	License type: CC BY 4.0

Affiliation: Fujian Medical University

Abstract

Pediatric obstructive sleep apnea-hypopnea syndrome is caused by multiple factors. The present study aimed to investigate the potential risks of pediatric obstructive sleep apnea hypopnea syndrome (OSAHS) and their correlation with the disease severity. A total of 338 pediatric patients with OSAHS (polysomnography (PSG) diagnosis) were enrolled between June 2008 and October 2010. These pediatric patients were divided into mild, moderate and severe subgroups according to the obstructive apnea index (OAI) and/or apnea hypoventilation index (AHI). A total of 338 pediatric patients with vocal nodules who were without obstruction of the upper respiratory tract were enrolled as the control group. The patients were analyzed retrospectively. The average number of upper respiratory tract infections each year and tonsil hypertrophy, adenoid hypertrophy, positive serum tIgE, chronic sinusitis, nasal stenosis, craniofacial features and obesity were significantly higher in OSAHS compared with controls (P<0.01). The parameters the average number of upper respiratory tract infections each year (OR: 1.395, 95% CI: 1.256–1.550), adenoid hypertrophy (OR: 8.632, 95% CI: 3.990–18.672), tonsil hypertrophy (OR: 9.138, 95% CI: 4.621–18.073), nasal stenosis (8.023, 95% CI: 3.633–17.717) and chronic sinusitis (OR: 27.186, 95% CI: 13.310–55.527) were independent factors of pediatric OSAHS (P<0.01). The distribution of chronic sinusitis, nasal stenosis, craniofacial features and obesity indicated a gradual increasing trend in the severity of OSAHS (P<0.01). Number of upper respiratory tract infections per year, adenoid hypertrophy, tonsil hypertrophy, chronic sinusitis, nasal stenosis, infections, allergic reactions, craniofacial features and obesity may be potential risk factors of pediatric OSAHS.

Highlights

The number of upper respiratory tract infections per year and the incidence of adenoid hypertrophy, tonsil hypertrophy, chronic sinusitis, nasal stenosis, positive serum tIgE, craniofacial features and obesity in the case group was significantly higher compared with that noted in the control group (P
Evaluation of the risk factors of obstructive sleep apnea-hypopnea syndrome (OSAHS) by multivariable logistic regression analysis The parameters that were significantly different as determined by univariable analyses were included in the logistic regression analysis, and the results showed that independent risk factors of pediatric OSAHS included adenoid hypertrophy, tonsil hypertrophy, nasal stenosis, chronic sinusitis and the average number of upper respiratory tract infection/year (Table 3)
The present study demonstrated that upper respiratory tract infection, allergic reactions-induced adenoid hypertrophy, tonsil hypertrophy, chronic sinusitis, nasal stenosis, certain craniofacial features and obesity may be considered risk factors for the development of pediatric OSAHS

Summary

Introduction

Risk factors for children with OSAHS interrupts normal ventilation in sleep resulting in intermittent hypoxia and hypercapnia, frequent arousals, and sleep fragmentation [1]. It may result in symptoms of habitual snoring (commonly with intermittent pauses, snorts, or gasps), disturbed sleep pattern, and daytime neurobehavioral problems [1]. This disturbs the normal ventilation and sleep of children, leading to a series of pathophysiological changes, such as growth restriction, behavioral abnormalities and cardiovascular disease. It rarely leads to death [4]

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