Risk Factors for Sleep-disordered Breathing in Children

TLDR

The study quantified how obesity, race, and respiratory problems influence sleep‑disordered breathing risk in children and adolescents. Researchers recruited 399 children aged 2–18 from families with a proband or neighborhood controls, assessed SDB via home overnight multichannel monitoring, and classified it using an apnea‑hypopnea index threshold of ≥10 for moderate disease. Moderate SDB was linked to obesity (OR 4.59) and African‑American race (OR 3.49), and after adjustment, sinus problems and persistent wheeze independently predicted SDB, underscoring obesity and respiratory issues as key risk factors and confirming that African‑American risk is independent of obesity or respiratory problems.

Abstract

This study examined risk factors for sleep-disordered breathing (SDB) in children and adolescents; specifically, quantifying risk associated with obesity, race, and upper and lower respiratory problems. Subjects were participants in a genetic-epidemiologic study of SDB and included 399 children and adolescents 2 to 18 yr of age, recruited as members of families with a member (a proband) with known sleep apnea (31 index families) or as members of neighborhood control families (30 families). SDB was assessed with home overnight multichannel monitoring and SDB was defined based on an apneahypopnea index ⩾ 10 (moderately affected) or < 5 (unaffected). SDB of moderate level was significantly associated with obesity (odds ratio, 4.59; 95% confidence interval [CI], 1.58 to 13.33) and African-American race (odds ratio, 3.49; 95% CI, 1.56 to 8.32) but not with sex or age. After adjusting for obesity, proband sampling, race and familial clustering, sinus problems and persistent wheeze each independently (of the other) predicted SDB. These data suggest the importance of upper and lower respiratory problems and obesity as risk factors for SDB in children and adolescents. Increased risk in African Americans appears to be independent of the effects of obesity or respiratory problems.