Obstructive Sleep Apnea Hypoventilation Syndrome Research Articles

Advances in non-coding RNA as a biomarker for obstructive sleep apnoea hypoventilation syndrome.

Obstructive sleep apnoea hypoventilation syndrome (OSAHS) is a common sleep disorder that affects multiple body systems, which in turn is closely associated with cognitive dysfunction, diabetes mellitus, oncological cardiovascular diseases and metabolic disorders. In recent years, non-coding RNA (ncRNA) has emerged as a new opportunity for biomarker discovery. We therefore discuss the research progress and potential role of ncRNAs in obstructive sleep apnea hypoventilation syndrome. This review systematically searched relevant academic literaturefrom PubMed, Web of Science and other databases. During the retrieval process, a combination ofkeywords such as "OSAHS", "ncRNA", "lncRNA", "miRAN", "circRNA" was used for search. Circulating ncRNA has good area under the ROC curve, sensitivity and specificity in the diagnosis ofOSAHS, and has the potential to become a diagnostic marker for OSAHS, while several circulatingncRNAs or circulating ncRNAs in combination with other tests such as the Obstructive Sleep ApnoeaScreening Scale have a higher value of application as a test for OSAHS.Further analyses revealed thatmany circulating ncRNAs were significantly differentially expressed in the serum of OSAHS patients withdifferent very severities, a potential marker for predicting the severity of OSAHS, and that the ncRNAcontent of patients' serum also had a significant effect during CPAP therapy, suggesting that it mayhave potential for therapeutic monitoring. Meanwhile, serum ncRNAs from patients have been shown tobe effective in the diagnosis of OSAHS complications such as hypertension, Alzheimer's disease, acutemyocardial infarction and atherosclerosis. The expression of up- or down-regulated ncRNAs can regulatedifferent signalling pathways, which in turn affects various OSAHS complications such as pulmonaryhypertension, diabetes mellitus, and cognitive dysfunction, and is expected to become a new directionfor the treatment of these complications. The changes in ncRNA expression in OSAHSpatients are expected to be a novel biomarker for the diagnosis and treatment of OSAHS, and can alsobe used as a potential biomarker for the combination of diabetes mellitus, cardiovascular disease,respiratory disease, and cognitive dysfunction in OSAHS. It is believed that the continuous progress ofncRNA-related research is expected to promote the early detection, diagnosis and treatment of OSAHSand its complications.

Risk factors and management countermeasures for obstructive sleep apnea hypoventilation syndrome in children.

Obstructive sleep apnea hypoventilation syndrome (OSAHS) in children is a sleep respiratory disorder characterized by a series of pathophysiologic changes. Statistics in recent years have demonstrated an increasing yearly incidence. To investigate the risk factors for OSAHS in children and propose appropriate management measures. This study had a case-control study design. Altogether, 85 children with OSAHS comprised the case group, and healthy children of the same age and sex were matched at 1:1 as the control group. Basic information, including age, sex, height, weight and family history, and medical history data of all study participants were collected. Polysomnography was used to detect at least 8 h of nocturnal sleep. All participants were clinically examined for the presence of adenoids, enlarged tonsils, sinusitis, and rhinitis. The analysis of variance revealed that the case group had a higher proportion of factors such as adenoid grading, tonsil indexing, sinusitis, and rhinitis than the control group. A regression model was established, and glandular pattern grading, tonsil indexing, sinusitis, and pharyngitis were identified as independent risk factors affecting OSAHS development.

Causal role of immune cells in obstructive sleep apnea hypopnea syndrome: Mendelian randomization study

BACKGROUND Despite being one of the most prevalent sleep disorders, obstructive sleep apnea hypoventilation syndrome (OSAHS) has limited information on its immunologic foundation. The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies (GWAS) and genotyping techniques using high-density genetic markers (e.g. , SNP or CNVs). But this tactic hasn't yet been applied to OSAHS. Using a Mendelian randomization analysis, we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS. AIM To investigate the immune cells' association with OSAHS via genetic methods, guiding future clinical research. METHODS A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS. Summary statistics for each immune cell feature were obtained from the GWAS catalog. Information on 731 immune cell properties, such as morphologic parameters, median fluorescence intensity, absolute cellular, and relative cellular, was compiled using publicly available genetic databases. The results' robustness, heterogeneity, and horizontal pleiotropy were confirmed using extensive sensitivity examination. RESULTS Following false discovery rate (FDR) correction, no statistically significant effect of OSAHS on immunophenotypes was observed. However, two lymphocyte subsets were found to have a significant association with the risk of OSAHS: Basophil %CD33dim HLA DR- CD66b- (OR = 1.03, 95%CI = 1.01-1.03, P < 0.001); CD38 on IgD+ CD24- B cell (OR = 1.04, 95%CI = 1.02-1.04, P = 0.019). CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach, thus offering direction for potential future medical research.

Moisture-Electric–Moisture-Sensitive Heterostructure Triggered Proton Hopping for Quality-Enhancing Moist-Electric Generator

HighlightsAn efficient moist-electric generator with ultra-fast electric response to moisture is achieved by triggering Grotthuss protons hopping in the moisture-electric–moisture-sensitive heterostructure.The moist-electric generator produces a quick response (0.435 s), an unprecedented ultra-fast response rate of 972.4 mV s−1 to alternating moisture stimulation and stable output for 8 h.An obstructive sleep apnea hypoventilation syndrome diagnostic system based on a moist-electric generator was developed to monitor hypopnea and apnea in real time and successfully diagnose them with early warning.

Modified oropharyngeal muscle training and scientific vocalization are effective in treating mild-to-moderate obstructive sleep apnea hypoventilation syndrome in adults

Background Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS) has become a major public health challenge globally. Most patients have a concomitant voice disorder. The existing treatment methods have problems.Aims/Objectives: This study investigates the therapeutic effect of adding scientific vocalization to oropharyngeal muscle training on OSAHS patients. Material and methods A total of 30 patients were selected from September 2020 to October 2022. They underwent overnight polysomnography (PSG) and were identified as having mild to moderate obstructive sleep apnea hypoventilation syndrome. They were then chosen for a three-month period of modified oropharyngeal muscle training combined with scientific vocalization. Results Out of the 30 selected patients, 26 patients completed the training. Results showed a significant changes in multiple sleep-related indicators. he clinical outcomes were as follows: 7 cases were cured, 13 cases were effective, and 6 cases were ineffective. The overall effective rate was 76.92%. Conclusions and significance The combination of oropharyngeal muscle training and scientific vocalization for the treatment of mild to moderate OSAHS in adults significantly improves several measures used in the treatment of the condition. The method is easy to learn, effective, safe to use, and affordable. It provides more options for the treatment of OSAHS.

Analysis of Heart Rate Variability in Obstructive Sleep Apnea Hypoventilation Syndrome

A total of 110 patients with obstructive sleep apnea hypoventilation syndrome were selected from January 2017 to December 2018, including 76 cases of men and 34 females, aged 40-50 y and according to the apnea hyponea index, patients were classified into 3 groups of moderate to moderate and 5 apnea hyponea index 20 was divided into group A (36 cases), the 40 of 20 to apnea hyponea index is divided into group B (45 cases) and apnea hyponea index the 40 of 20 to 40 is divided into group B (45 cases) and apnea hyponea index to 40 is divided into group C (29 cases). In the same period in the health check-up center to extract 40 cases without obstructive sleep apnea hypopnea syndrome, arrhythmia and other medical history of health check-up objects. 24 h Holter-monitoring and polysomography monitoring of 4 groups of people, observed and recorded heart rate variability indicators for each group, including all standard deviations for sinus cardiac arrest, standard deviation per 5 min sinus cardiac interstitial period, the average root mean square of successive differences of the total sinus intercardial period difference is divided by the number of individuals of the sinus cardiac interstitial period of 50 ms the average root mean square of successive differences of the total sinus intercardial period difference is divided by the number of individuals of the sinus cardiac inner struggle period of 50 ms divided by the percentage of the total sinus cardiac inner struggle period (proportion of NN50), low frequency and high frequency. Standard deviation of all sinus beats, standard deviation of the mean value of sinus, root mean square of successive differences, proportion of NN50, low frequency and high frequency were lower than those in the control group (p<0.05) in patients with obstructive sleep apnea hypopnea syndrome. The proportion of NN50 and high frequency in group C were lower than A and B (p<0.05) and the low frequency was higher than the proportion of NN50 and high frequency in group C were lower than A and B (p<0.05) and the low frequency was higher than group A, group B and control group (p<0.05). Holter-monitoring is a non-invasive test, the price is not high and it can be a regular test for testing the autonomic nervous function in patients with obstructive sleep apnea hypopnea syndrome.

Increased diastolic blood pressure and apnea time contribute to the poor apnea and hypopnea index and life quality of primary snoring: a cohort study combined with external validation.

Obstructive sleep apnea hypoventilation syndrome (OSAHS) is a common sleep breathing disorder closely associated with cardiovascular disease. However, the respiratory sleep and related cardiovascular parameters on the apnea and hypopnea index (AHI) and life quality of primary snoring are unclear. We launched a cohort study focused on the association between respiratory sleep and cardiovascular-related parameters and apnea and hypopnea index, incorporating data from 218 patients with primary snoring in our medical center between Jun 1, 2015, and Apr 1, 2016. Thirty patients from Sichuan Cancer Hospital were used for validation. Patients with longer apnea time were more likely to progress to higher AHI (> 30) than controls (OR = 5.66, 95% CI = [2.79, 11.97], p < 0.001). Similarly, if patients have a higher value of diastolic blood pressure, they will also have a higher AHI (> 30) (HR [95% CI] = 3.42 [1.14, 13.65], p = 0.043). According to multivariate analysis, longest apnea time, the mean percentage of SaO2, and neckline length were independent risk factors of overall survival. A predictive model developed based on these factors above yielded a favorable agreement (C-index = 0.872) on the calibration curve. Thirty patients conducted external validation from Sichuan Cancer Hospital, displaying an AUC of 0.833 (0.782-0.884). Increased diastolic blood pressure and apnea time affect AHI level. An AHI prediction model based on these factors above can help clinicians predict the risk of high AHI events.

Differences of Sleep Disorders Between Vestibular Migraine and Benign Paroxysmal Positional Vertigo.

Introduction: Sleep disorders can affect the overall health and quality of life of patients. This study was conducted to compare the differences of sleep disorders in vestibular migraine (VM) patients and benign paroxysmal positional vertigo (BPPV) patients.Methods: VM patients, BPPV patients, and healthy controls (HCs) were recruited. Pittsburgh sleep quality index and polysomnography monitoring were used as subjective and objective, respectively, evaluation methods to evaluate the sleep quality of participants in the latest month.Results: Fifty-seven BPPV patients, 48 VM patients, and 42 HCs were included in this study. There were 79.16% VM patients, 54.39% BPPV patients, and 14.28% HCs with sleep disorders. The difference in the incidence rate of sleep disorders was significant between VM patients and BPPV patients (p = 0.008) and significantly higher in both the VM group (p < 0.00001) and BPPV group (p = 0.00004) than in the HC groups (14.28%). Compared with BPPV patients, the VM patients had the significantly lower sleep efficiency (p < 0.001) and N3 (p < 0.001) and the significantly higher time of wake-up after sleep onset (p < 0.001), N1 (p < 0.001), and N2 (p < 0.001). Meanwhile, the VM patients had significantly higher incidence rates of severe obstructive sleep apnea hypoventilation syndrome (p = 0.001) and periodic leg movement in sleep (p = 0.016).Conclusion: The incidence rate of sleep disorders was significantly higher in both VM and BPPV patients than in the HC groups. To improve the curative effects, clinicians should pay more attention to the comorbidity of sleep disorders in treating VM and BPPV.

Clinical features and related risk factors of sleep hypopnea in obstructive sleepapnea hypoventilation syndrome

Clinical features and related risk factors of sleep hypopnea in obstructive sleepapnea hypoventilation syndrome

Questionnaire survey onobstructive sleep apnea hypoventilation syndrome and related complications

：Objective To investigaterelationship between obstructive sleep apnea hypoventilation syndrome(OSAHS) andhypertension.Methods Questionnaire survey was conducted among 1573 local permanentresidents in Guangzhou during March and June 2006 to understand prevalence of hypertensionand snoring,and polysomnography monitoring was performed for 347 of them with moderate andsevere snoring to estimate prevalence of OSAHS.Risk factors for hypertension was screenedwith multivariate logistic regression analysis.Results In total,1547 copies of validquestionnaires were collected,and 184 cases (11.9%) of hypertension were found with aprevalence of 10Department of Endocrinology,Shanxi Provincial People's Hospital,Taiyuan030012,China 0%,49 of diabetes with a prevalence of 2.7%,and 212 of dyslipidemia with aprevalence of 10.4%.Prevalence of OSAHS was found in 34 of them (2.2% ) with Epworthsleepiness scale (ESS) score equal to or greater than nine.Prevalence of hypertension inOSAHS group was 32.5%,much higher than that in non-snoring group (8.3% ) and snoring group( 17.1% ).Results of logistic regression analysis showed that age,gender,OSAHS,diabetesand dyslipidemia all were high-risk factors for hypertension,with OSAHS ranking thethird.Conclusion OSAHS is one of high-risk factors for hypertension.

THE APPLICATION OF WAVELET ANALYSIS ON THE EVALUATION OF SLEEP EEG FROM OBSTRUCTIVE SLEEP APNEA HYPOVENTILATION

PURPOSE: Wavelet transformation was used to analyze the sleep EEG signal of the obstructive sleep apnea hypoventilation syndrome (OSAHS) patients for the purpose of finding reliable parameter reflecting the disease severity.

Relationship between oxidative stress and endothelial cell apoptosis in patients with obstructive sleep apnea-hypoventilation syndrome

Objective To study the relationship between oxidative stress and endothelial cell apoptosis in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS). Methods Sixth-seven patients definitely diagnosed by potysomnography (PSG) as OSAHS were divided into three groups according to their apnea-hypoventilation index (AHI), 14 in mild group (5 < AHI≤20), 21 in moderate group (20 < AHI≤40) and 32 in severe group (AHI 40). And, 18 healthy persons (AHI <5) were recruited as controls. Blood samples were obtained form all of them after PSG performance for measuring apoptotic endothelial cells (CD146AnnV+) and serum levels of superoxide dismutase (SOD) and malondialdehyde (MDA). Results Serum level of MDA and CD146AnnV+ in moderate and severe OSAHS group were significantly higher than those in control group (all P < 0.05). Serum level of SOD in moderate and severe OSAHS group was significantly lower than that in control group (P < 0.05). CD146AnnV+ correlated positively with AHI, the longest apnea time (LAT) and oxygen desaturation index (ODI) (r = 0.778, 0.609 and 0.689, respectively, all P < 0.05) and correlated reversely with saturation of arterial blood oxygen at night (SaO2min) (r =-0.635, P < 0.01). CD146AAnnV+ correlated positively with serum level of MDA (r = 0. 698, P < 0.01), and correlated reversely with serum level of SOD (r =-0.705, P < 0.01). Results of linear multivariate regression analysis showed that AHI, serum levels of SOD and MDA were independent risk factors for endothelial cells apoptosis in patients with OSAHS. Conclusions There existed oxidative stress due to intermittent hypoxia in patients with OSAHS, which could be one of the major causes in exacerbating endothelial damage. Key words: Sleep apnea-hypopnea, obstructive; Vascular endothelial cell; Apoptosis; Oxidative stress

Change of diaphragm electromyograms in patients with obstructive sleep apnea-hypoventilation syndrome and its significance

Objective To explore change of diaphragm electromyograms in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS) before and after nocturnal sleep, as well as effective nasal continuous positive airway pressure (n-CPAP) ventilation treatment for more than two months. Methods Diaphragm electromyogram was recorded with chest surface electrodes in 22 patients with moderate and severe OSAHS and 24 normal people, and phrenic nerve conduction time (PNCT) and diaphragm compound muscle action potential (CMAP) provoked by unilateral magnetic stimulation (UMS) were measured for them before and after sleep. Measurements were repeated for five patients with severe OSAHS after effective OSAHS patients before and after nocturnal sleep than that in normal people bilaterally, (8.4±0. 6)ms and (8.4±0. 9)ms vs (7. 3±0. 8)ms and (7. 3±0. 8) ms for the left side; and (8.4±1.3) ms and (8. 9 ± 0. 8) ms vs (7.2 ± 0. 8) ms and (7.2 ± 0. 8 ) ms for the right side ( P < 0. 01 ), respectively ; and amplitude of CMAP was significantly lower in OSAHS patients, (0. 60±0. 20)mV and (0. 64±0. 29)mV vs (0. 98 ± 0. 28)mV and (0. 97±0. 27)mV for the left side; and (0. 53±0. 23)mV and (0. 56±0. 26)mV vs (0. 93 ±0. 29) mV and ( 0. 94 ± 0. 29 ) mV for the right side, respectively ( P < 0. 01 ) ; but no significant significantly shortened bilaterally in five patients with severe OSAHS after effective n-CPAP ventilation treatment for more than two months, (8.6±0. 7)ms vs (7.4±0. 5)ms for the lfet side and (7. 8±0. 6)ms vs (6.4 ± 0. 6) ms for the fight side ( P < 0. 05 ), respectively. Conclusions Both phrenic nerve conduction and diaphragm muscle function are weakened in patients with OSAHA, which may be related to hypoxia and/ or disturbance of sleep structure at night. Key words: Sleep apnea, obstructive; Phrenic nerve; Diaphragm electromyogram

Clinical observations of metabolic disturbance in patients with obstructive sleep apnea-hypoventilation syndrome

Objectives To investigate the relationship between obstructive sleep apnea hypoventilation syndrome (OSAHS), insulin resistance (IR) and metabolic syndrome (MS), as well as to explore the possible mechanism of MS caused by OSAHS. Methods We recruited 186 hospitalized patients with hypertensions, who were divided into four groups based on their nocturnal polygraphs recordings, 35 as controls (group Ⅰ), 61 with mild (group Ⅱ), 52 with moderate (group Ⅲ) and 38 with severe OSAHS (group Ⅳ). They all underwent measurements including body height, body weight, waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), serum uric acid, creatinine, fasting plasma glucose, fasting plasma insulin, serum total cholesterol, high-density lipoprotein-cholesterul, low-density lipoprotein-cholesterol and triglyceride. Results One hundred and two patients with OSAHS (67.6 percent) also suffered of MS, 33 (86.8 percent) of them with severe OSAHS. There was no significant difference in age, gender, fasting plasma glucose, total cholesterol, high-density lipoprutein-cholesterul, low-density lipoprotein-cholesterol and triglyceride among the four groups (P>0.05). Body mass index (BMI), WC, ratio of serum uric acid to creatinine and DBP were all significantly higher in patients with severe OSAHS than those in patients with mild and moderate OSAHS and controls (P<0.01). SBP was significantly higher in patients with severe OSAHS than that in those with mild and moderate OSAHS (P<0.01). Insulin resistance was significantly severer in patients with severe OSAHS than that in those with mild OSAHS and controls (P<0.01). Results of multivariate linear regression analysis showed that insulin resistance was correlated with BMI and reversely correlated with minimal blood oxygen saturation, and minimal blood oxygen saturation reversely correlated with WC and ratio of uric acid to creatinine. Condusions Hypoxemia and obesity may promote development of insulin resistance. Patients of hypertension complicated with OSAHS tend to develop MS, particularly in those with severe OSAHS. Key words: Sleep apnea,obstructive; Metabolic syndromeX; Insulin resistance

Changes in blood hemorheology and early morning blood pressure in patients with obstructive sleep apnea-hypoventilation syndrome

Objective To investigate changes in morning blood pressure surge (MBPS) and blood hemorheology in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS) of various severity. Methods Total 118 patients with OSHAS diagnosed at the Department of Respiratory Diseases, People's Hospital of Guizhou Province were divided into three groups, i.e. , 31 mild, 40 moderate and 47 severe cases, based on their apnea-hypoventilation index (AHI), and 25 healthy persons were selected as controls. Blood hemorheology, oxygen saturation, morning blood pressure surge of the patients, as well as percentage of the time with oxygen saturation more than 90 percent of the total monitoring time (TS90%) were recorded. Results Early morning blood pressure surge was found in 21 cases (43%) with severe, eight (20%) with moderate and one (3%) with mild OSAHS. All indicators of blood hemarheology and TS90% were significantly higher in the patients with OSAHS than those in controls (P<0.05 ), those in moderate and severe OSAHS were significantly higher than those in controls (P<0.05 ) and those in severe OSAHS was significantly higher than those in moderate and mild OSAHS (P<0.05). All indicators of blood hemorheology were significantly higher in those with early morning blood pressure surge than those without it (P<0.05). Conclusions Blood viscosity, percentage of early morning blood pressure surge and TS90% in the patients with OSAHS are increased with severity of apnea-hypoventilation, and changes in blood hemorheology correlated with early morning blood pressure surge. Key words: Sleep apnea, obstructive; Hemorheology; Blood pressure

Three-year follow-up of overlap syndrome

Objective To analyze the clinical features of overlap syndromes(OS),I.e.,chronic obstructive pulmonary disease(COPD)complicated with obstructive sleep apnea hypoventilation syndrome (OSAHS).Methods Frequency of episodes of acute exacerbation,severity,quality of life,exercise endurance,complications and three-year survival rate were investigated in eight patients with OS and 10 patients with pure COPD.Results Both quality of life and exercise endurance in OS group were lower than those in COPD group(P＜0.05).Annual frequency of acute exacerbation episodes and severity were more and three-year survival rate was lower in OS group than those in COPD group(P＜0.05).Complications of hypertension,diabetes,erythrocythemia,respiratory failure and heart failure were all more frequent in OS group than those in COPD group.Among all the above clinical features,increased frequency of acute exacerbation episodes was the most significant.Conclusions OS is clinically more severe than pure COPD,so more attention should be paid to it.Survival for patients with OS can not extended by nocturnal oxygen therapy alone,which may be beneficial when combined with biphasic positive airway pressure(BiPAP)or continuous positive airway pressure(CPAP)ventilation. Key words: Lung diseases,obstructive; Sleep apnea syndromes; Quality of life; Survival rate

Clinical value of TS90% in evaluation of hypoxemia in patients with obstructive sleep apnea/hypoventilation syndrome

To explore the appropriate study how to properly evaluate the hypoxemia degree in patients with obstructive sleep apnea/hypoventilation syndrome (OSAHS). polysomnography was conducted on 108 OSAHS patients and 37 simple snorers to record the minimum oxygen saturation level (MiO(2)) and the total recorded time spent below 90% oxygen saturation (TS90%). The correlation between MiO(2) and the percent of the total recorded time spent below 90% oxygen saturation (TS90%) with the AHI were calculated. The value of TS90% was significantly increased, and the value of MiO(2) was significantly decreased as the severity of OSAHS increased (all P < 0.001). The correlation coefficients of TS90% with AHI and with Epworth sleepiness scale (ESS) were both much higher than those of MiO(2). TS90% can express the severity of hypoxemia of the OSAHS patients more correctly than MiO(2). TS90% combined with MiO(2) can comprehensively and objectively reflect the severity of hypoxia of the OSAHS patients.

Clinical features of obstructive sleep apnea hypoventilation syndrome in otherwise healthy children.

Obstructive sleep apnea hypoventilation syndrome (OSAHS) is an important public health problem. However, major gaps exist in our knowledge about the clinical features of this disorder in the pediatric age group. The purpose of this study was to examine clinical features of OSAHS diagnosed by polysomnography in otherwise healthy children. In this cross-sectional study, 326 children without underlying medical conditions (5.8+/-3.0 years, range 1-12 years; 56% male) were recruited from patients referred by primary care and otorhinolaryngology physicians for evaluation of snoring and difficulty breathing. Ethnic group distribution was African-American (38%), Caucasian (30%), and Hispanic (31%). Complaints of daytime tiredness or sleepiness were reported in 29% of the children. All children underwent overnight polysomnography (N = 330 studies). OSAHS was diagnosed in 59% of the children, based on polysomnographic criteria. The remaining children had either primary snoring (25%); no snoring (10%), or upper airway resistance syndrome (6%). Neither male gender nor obesity increased the likelihood for the diagnosis of OSAHS. However, the incidence of obesity in the study population (28%) was more than twice that of the general pediatric population. African-American children had a greater likelihood for OSAHS diagnosis compared to Hispanic or Caucasian children. Daytime complaints of sleepiness or tiredness were not more common in children diagnosed with OSAHS than in the children without OSAHS. As expected, tonsillar hypertrophy increased the likelihood of OSAHS diagnosis. In summary, many of the clinical features of childhood OSAHS are in marked contrast to those in adults.