Materiały źródłowe

• #1 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. […] We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. […] In the face of these limitations, estimated population prevalences are as follows: parent-reported always snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. […] Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.759.61).

• #2 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  If left untreated, pediatric OSA can have serious morbidities and long-term complications. Sustained hypoxia can increase pulmonary vasoconstriction and lead to pulmonary hypertension and right heart failure at an early age. Cognitive dysfunction, impaired learning, and poor school performance are associated with undiagnosed and untreated pediatric OSA. Additionally, increased work of breathing can be associated with failure to thrive seen in younger populations.[2]

• #3 Pediatric obstructive sleep apnea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/symptoms-causes/syc-20376196

  Pediatric obstructive sleep apnea is a condition in which a child’s breathing is partly or completely blocked during sleep. […] Obstructive sleep apnea can look different in children than it does in adults. […] The main risk factor for pediatric obstructive sleep apnea is enlarged tonsils and adenoids, especially in younger children. […] Without treatment, pediatric obstructive sleep apnea can lead to other health conditions called complications. […] Rarely, pediatric obstructive sleep apnea can cause infants and young children not to grow as much as those who don’t have the condition. […] Children who don’t receive treatment also may have a higher risk of later complications such as high blood pressure, high cholesterol, and a higher than typical blood sugar level that raises the risk of diabetes.

• #4 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  Sleep-disordered breathing (SDB) conditions include the major group of obstructive SDB and other less frequent categories such as central sleep apnea (CSA), central congenital hypoventilation syndrome (CCHS), apnea of prematurity, apparent life-threatening events (ALTEs), and brief resolved unexplained events (BRUEs. […] In the general pediatric population, the prevalence of OSA varies between 2% and 5%, but in some particular clinical conditions, it can be much higher. […] According to the American Academy of Pediatrics’ (APP) 2012 guidelines, the prevalence of OSA in the pediatric population is about 1.2–5.7%. […] Similarly, the European Respiratory Society’s (ERS) 2016 statement, referring to a meta-analysis of published studies, reports the prevalence of OSA in a range from 0.1 to 13%, among which most studies show a frequency between 1% and 4%.

• #5 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  Sleep-disordered breathing (SDB) conditions include the major group of obstructive SDB and other less frequent categories such as central sleep apnea (CSA), central congenital hypoventilation syndrome (CCHS), apnea of prematurity, apparent life-threatening events (ALTEs), and brief resolved unexplained events (BRUEs. […] In the general pediatric population, the prevalence of OSA varies between 2% and 5%, but in some particular clinical conditions, it can be much higher. […] According to the American Academy of Pediatrics’ (APP) 2012 guidelines, the prevalence of OSA in the pediatric population is about 1.2–5.7%. […] Similarly, the European Respiratory Society’s (ERS) 2016 statement, referring to a meta-analysis of published studies, reports the prevalence of OSA in a range from 0.1 to 13%, among which most studies show a frequency between 1% and 4%.

• #6 Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae

  https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2010.53.10.863

  The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. […] OSAS has been estimated to affect about 2-3.5% of children. […] OSAS prevalence has 2 peak periods. The first peak occurs in children from 2 to 8 years of age, with the presence of enlarged adenoid and/or tonsils. A second peak arises during adolescence in relation with weight gain. […] The prevalence of sleep-disordered breathing in Korean children has not been reported. […] Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

• #7 Pediatric Obstructive Sleep Apnea | Ento Key

  https://entokey.com/pediatric-obstructive-sleep-apnea/

  Screening for obstructive sleep apnea (OSA) with in-laboratory polysomnography is recommended for children with sleep disordered breathing. […] OSA is documented in 1% to 5% of children. […] Numerous studies report that OSA is associated with decreased neurocognitive, behavioral, and quality-of-life scores, as well as increased systemic blood pressure, increased pulmonary sequelae, and increased health care use. […] Early identification can expedite treatment and prevent or reverse many of these negative health consequences. […] Conditions associated with an increased prevalence of pediatric OSA include: Male gender, especially in adolescents; Black race; Family history of OSA; Prematurity; Obesity; Allergic rhinitis; Down syndrome; Prader-Willi syndrome; Neuromuscular disorders; Chiari malformations/myelomeningocele; Craniofacial anomalies (eg, achondroplasia and Pierre Robin sequence).

• #8 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. […] We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. […] In the face of these limitations, estimated population prevalences are as follows: parent-reported always snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. […] Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.759.61).

• #9 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. […] We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. […] In the face of these limitations, estimated population prevalences are as follows: parent-reported always snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. […] Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.759.61).

• #10 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. […] We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. […] In the face of these limitations, estimated population prevalences are as follows: parent-reported always snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. […] Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.759.61).

• #11 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. […] We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. […] In the face of these limitations, estimated population prevalences are as follows: parent-reported always snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. […] Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.759.61).

• #12 Obstructive Sleep Apnea in Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0301/p1147.html

  Obstructive sleep-disordered breathing is common in children. From 3 percent to 12 percent of children snore, while obstructive sleep apnea syndrome affects 1 percent to 10 percent of children. […] The estimated prevalence of snoring in children is 3 to 12 percent, while OSA affects 1 to 10 percent. […] Sleep-disordered breathing in children is a timely public health concern, given the increasing rates of obesity and hyperactivity in this population. […] The role of polysomnography in the diagnosis of childhood sleep-disordered breathing remains controversial. Although polysomnography is the current gold standard, authorities cite the lack of reliable sleep laboratories for children, excess cost, and lack of consensus on interpretation of polysomnograms as reasons it is not required for diagnosis. […] Adenotonsillectomy remains the treatment of choice for most children with a strong clinical history of OSA or with OSA documented by polysomnography.

• #13 Pediatric sleep disordered breathing: a narrative review – Narayanasamy – Pediatric Medicine

  https://pm.amegroups.org/article/view/5050/html

  Pediatric sleep disordered breathing is a spectrum of ventilatory disorders associated with multisystem complications. This narrative review aimed to discuss the impact of obstructive sleep apnea (OSA) in pediatric patients, the presentation and phenotypic variations, sleep disordered breathing in special populations, screening for suspected sleep apnea, diagnosis and management of pediatric OSA. […] OSA is a multisystem disorder associated with various short term and long term complications. There are numerous challenges with screening and diagnosis which leaves high number of undiagnosed OSA. […] Prevalence of pediatric OSA varied between 15% depending on the population and age group studied and the prevalence of habitual snoring up to 27.5% depending on the study and definition used. The prevalence is significantly higher in obese children, patients with down syndrome, cerebral palsy, prematurity and craniofacial abnormalities. The prevalence is reported to be four to five-fold higher in obese children. Based on PSG in a large cohort of patients with down syndrome, the prevalence of OSA is reported to be 66%.

• #14 :: Sleep Medicine Research

  https://www.sleepmedres.org/m/journal/view.php?number=269

  Prevalence of obstructive sleep apnea (OSA) in children is a significant concern, with a study determining its prevalence at 8.13% among 69-year-old children in Visnagar. […] The prevalence of sleep-disordered breathing is extremely high, yet it is largely ignored. […] OSA prevalence was determined 8.13% in the Visnagar population of children and adolescents aged 6 to 9 years using the FAIREST and BEARS questionnaire. […] Numerous population-based studies have been conducted and published on the prevalence of sleep-disordered breathing (SDB) and its effects. […] Pediatric OSA is extremely prevalent, impacting 1%4% of the general pediatric population, per the American Association of Pediatric Dentistry in 2002. […] The current study, utilizing FAIREST-6 and BEARS questionnaire scores, determined the prevalence of OSA among children aged 6 to 9 years to be 8.13%. […] The findings of the current study, as obtained through the implementation of a questionnaire, are subject to the subjective interpretations of parents, thereby presenting a limitation.

• #15 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  Childhood sleep apnea is characterized as airway obstruction because of upper airway impairment due to reduced oxygen levels or awakening from sleep in children. […] In children, only 15% of children suffer from sleep apnea, which equals to about 20 million100 million children, globally. […] However, childhood sleep apnea tends to be underdiagnosed with about 90% of children not being properly diagnosed with sleep apnea. […] Childhood risk factors are important to consider because they can increase risk and severity. […] To aid an efforts to relieve, prevent, and diagnose childhood sleep apnea, there needs to be more efforts to promote, to educate, and to implement diagnostic testing for sleep apnea as a standard of care in pediatric patients. […] While the prevalence of sleep apnea is lower in children than adults, childhood sleep apnea is usually not diagnosed as frequently as in adults.

• #16 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  About 90% of children are underdiagnosed for sleep apnea. […] Studies have shown that Black children have a higher odds of developing sleep apnea and often have a 20% increase in the severity of sleep apnea. […] The prevalence of sleep apnea in Black children is 47.1%, the prevalence of sleep apnea in Hispanic children in 12.5%, and the prevalence of sleep apnea in White children is 40.4%. […] The prevalence of sleep apnea for children between the ages 04 years is 0.66%, the prevalence of sleep apnea for children between the ages of 59 years is 1.37%, the prevalence of sleep apnea for children between the ages of 1014 years is 1.56%, and the prevalence of sleep apnea for children between the ages of 1519 years is 1.14%. […] 15% of children with sleep apnea have tonsillar hypertrophy.

• #17 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #18 Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae

  https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2010.53.10.863

  The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. […] OSAS has been estimated to affect about 2-3.5% of children. […] OSAS prevalence has 2 peak periods. The first peak occurs in children from 2 to 8 years of age, with the presence of enlarged adenoid and/or tonsils. A second peak arises during adolescence in relation with weight gain. […] The prevalence of sleep-disordered breathing in Korean children has not been reported. […] Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

• #19 Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae

  https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2010.53.10.863

  The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. […] OSAS has been estimated to affect about 2-3.5% of children. […] OSAS prevalence has 2 peak periods. The first peak occurs in children from 2 to 8 years of age, with the presence of enlarged adenoid and/or tonsils. A second peak arises during adolescence in relation with weight gain. […] The prevalence of sleep-disordered breathing in Korean children has not been reported. […] Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

• #20 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  The rise in the incidence of obesity in children and adolescents is leading to an epidemiological transition of obstructive SDB from the classic phenotype to the obese adult phenotype, with a peak incidence in adolescence. […] The prevalence of OSA in children with Down syndrome is very high compared to that in the general population (range, 31–79%), due to particular craniofacial features, adenotonsillar hypertrophy, hypotonia, and obesity. […] The prevalence of SDB in patients with neuromuscular disorders depends on the type of disease and the diagnostic criteria used.

• #21 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  About 90% of children are underdiagnosed for sleep apnea. […] Studies have shown that Black children have a higher odds of developing sleep apnea and often have a 20% increase in the severity of sleep apnea. […] The prevalence of sleep apnea in Black children is 47.1%, the prevalence of sleep apnea in Hispanic children in 12.5%, and the prevalence of sleep apnea in White children is 40.4%. […] The prevalence of sleep apnea for children between the ages 04 years is 0.66%, the prevalence of sleep apnea for children between the ages of 59 years is 1.37%, the prevalence of sleep apnea for children between the ages of 1014 years is 1.56%, and the prevalence of sleep apnea for children between the ages of 1519 years is 1.14%. […] 15% of children with sleep apnea have tonsillar hypertrophy.

• #22 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #23 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #24 Childhood Sleep Apnea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1004104-overview

  Sex distribution […] The male-to-female ratio of obstructive sleep apnea in children is approximately 1:1. At puberty, the male-to-female ratio starts to increase. In older adolescents, a male preponderance emerges that essentially reflects the typical male predominance observed in the adult population. By adulthood, symptomatic men outnumber symptomatic women by 2:1 or more. […] Age distribution […] Obstructive sleep apnea is observed in children of all ages and may develop even in infancy. Retrospective studies note that a large number of parents with children in whom obstructive sleep apnea is diagnosed recall that their child’s snoring began within the first months of life. Preterm babies are at risk for more obstructive events while supine, but some have suggested that they are still at a lower risk of death from sudden infant death syndrome. However, Moon et al, citing 3 studies, report that premature infants may be at 4 times increased risk for sudden infant death syndrome compared with term infants, with the risk increasing at lower gestational age and birthweight. […] Most children with obstructive sleep apnea are aged 2-10 years (coinciding with adenotonsillar lymphatic tissue growth). Children with severe obstructive apnea are likely to present when aged 3-5 years. The mean age at diagnosis has been reported to be 14 months, plus or minus 12 months.

• #25 Childhood Sleep Apnea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1004104-overview

  Sex distribution […] The male-to-female ratio of obstructive sleep apnea in children is approximately 1:1. At puberty, the male-to-female ratio starts to increase. In older adolescents, a male preponderance emerges that essentially reflects the typical male predominance observed in the adult population. By adulthood, symptomatic men outnumber symptomatic women by 2:1 or more. […] Age distribution […] Obstructive sleep apnea is observed in children of all ages and may develop even in infancy. Retrospective studies note that a large number of parents with children in whom obstructive sleep apnea is diagnosed recall that their child’s snoring began within the first months of life. Preterm babies are at risk for more obstructive events while supine, but some have suggested that they are still at a lower risk of death from sudden infant death syndrome. However, Moon et al, citing 3 studies, report that premature infants may be at 4 times increased risk for sudden infant death syndrome compared with term infants, with the risk increasing at lower gestational age and birthweight. […] Most children with obstructive sleep apnea are aged 2-10 years (coinciding with adenotonsillar lymphatic tissue growth). Children with severe obstructive apnea are likely to present when aged 3-5 years. The mean age at diagnosis has been reported to be 14 months, plus or minus 12 months.

• #26 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  About 90% of children are underdiagnosed for sleep apnea. […] Studies have shown that Black children have a higher odds of developing sleep apnea and often have a 20% increase in the severity of sleep apnea. […] The prevalence of sleep apnea in Black children is 47.1%, the prevalence of sleep apnea in Hispanic children in 12.5%, and the prevalence of sleep apnea in White children is 40.4%. […] The prevalence of sleep apnea for children between the ages 04 years is 0.66%, the prevalence of sleep apnea for children between the ages of 59 years is 1.37%, the prevalence of sleep apnea for children between the ages of 1014 years is 1.56%, and the prevalence of sleep apnea for children between the ages of 1519 years is 1.14%. […] 15% of children with sleep apnea have tonsillar hypertrophy.

• #27 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  About 90% of children are underdiagnosed for sleep apnea. […] Studies have shown that Black children have a higher odds of developing sleep apnea and often have a 20% increase in the severity of sleep apnea. […] The prevalence of sleep apnea in Black children is 47.1%, the prevalence of sleep apnea in Hispanic children in 12.5%, and the prevalence of sleep apnea in White children is 40.4%. […] The prevalence of sleep apnea for children between the ages 04 years is 0.66%, the prevalence of sleep apnea for children between the ages of 59 years is 1.37%, the prevalence of sleep apnea for children between the ages of 1014 years is 1.56%, and the prevalence of sleep apnea for children between the ages of 1519 years is 1.14%. […] 15% of children with sleep apnea have tonsillar hypertrophy.

• #28 Childhood Sleep Apnea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1004104-overview

  Epidemiology […] In nonobese and otherwise healthy children younger than 8 years, the prevalence of obstructive sleep apnea is estimated to be 1-3%. Habitual snoring is common during childhood and affects approximately 10% of children aged 2-8 years; the frequency decreases after age 9-10 years. Obesity confers 4-fold to 5-fold added risk for sleep-disordered breathing. In children and adolescents with coexisting medical conditions such as trisomy 21, the prevalence of obstructive sleep apnea may be as high as 80%. […] In the United Kingdom, approximately 1.75-2.25% of children aged 4-5 years are thought to have obstructive sleep apnea. Unfortunately, very few epidemiologic studies of childhood obstructive sleep apnea are available. […] Racial distribution […] Obstructive sleep apnea occurs more commonly among Black and Hispanic individuals than among White adults and children. In patients younger than 18 years, Blacks are 3.5 times more likely to develop obstructive sleep apnea than Whites. […] The high frequency of obstructive sleep apnea in adult Asian populations indicates that the anthropometric characteristics of the craniofacial structures in this racial group also predispose to higher obstructive sleep apnea rates in children. The frequency of obstructive sleep apnea in Hispanic children is equal to that of White children.

• #29 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  The same meta-analysis reports a prevalence of habitual snoring of 7.45%, including some studies which documented a prevalence as high as 35% or as low as 3%. […] The description of pediatric OSA epidemiology and, in general, obstructive SDB is critical, due to a plethora of methodologic issues, most of which involve heterogeneity in diagnostic criteria, children’s age, and presence of medical and neurologic morbidities. […] The majority of SDB in children is obstructive and includes a spectrum of conditions, ranging from habitual snoring (prevalence, 7.45%; range, 3–35%) to OSA (prevalence, 2–5%; range, 0.1–13%). […] Adenotonsillar hypertrophy (classic phenotype) is the most common risk factor for obstructive SDB in healthy children, with a peak incidence between 2 and 8 years of age.

• #30 Obstructive Sleep Apnea in Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0301/p1147.html

  Obstructive sleep-disordered breathing is common in children. From 3 percent to 12 percent of children snore, while obstructive sleep apnea syndrome affects 1 percent to 10 percent of children. […] The estimated prevalence of snoring in children is 3 to 12 percent, while OSA affects 1 to 10 percent. […] Sleep-disordered breathing in children is a timely public health concern, given the increasing rates of obesity and hyperactivity in this population. […] The role of polysomnography in the diagnosis of childhood sleep-disordered breathing remains controversial. Although polysomnography is the current gold standard, authorities cite the lack of reliable sleep laboratories for children, excess cost, and lack of consensus on interpretation of polysomnograms as reasons it is not required for diagnosis. […] Adenotonsillectomy remains the treatment of choice for most children with a strong clinical history of OSA or with OSA documented by polysomnography.

• #31 Obstructive Sleep Apnea in Pediatric Patients | RT

  https://respiratory-therapy.com/disorders-diseases/sleep-medicine/obstructive-sleep-apnea-in-pediatric-patients/

  Enlarged tonsils and adenoids are the leading cause of OSA in children. […] SDB is a consequence of childhood obesity for which aggressive evaluation and therapy are warranted. […] It is important that all health care professionals who treat children be familiar with the symptoms of OSA. […] Despite having a different (and, sometimes, more subtle) clinical presentation than that seen in adults, children often have unexpected degrees of airway obstruction, impairment of gas exchange, and sleep disturbance that are difficult to predict on the basis of clinical history and physical examination alone. […] Polysomnography has been the gold standard for the diagnosis of OSA in adults and is equally useful in determining its presence and severity (as well as the efficacy of treatment for it) in children. […] Nearly 10% of children who snore have significant sleep and breathing disorders.

• #32 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  About 90% of children are underdiagnosed for sleep apnea. […] Studies have shown that Black children have a higher odds of developing sleep apnea and often have a 20% increase in the severity of sleep apnea. […] The prevalence of sleep apnea in Black children is 47.1%, the prevalence of sleep apnea in Hispanic children in 12.5%, and the prevalence of sleep apnea in White children is 40.4%. […] The prevalence of sleep apnea for children between the ages 04 years is 0.66%, the prevalence of sleep apnea for children between the ages of 59 years is 1.37%, the prevalence of sleep apnea for children between the ages of 1014 years is 1.56%, and the prevalence of sleep apnea for children between the ages of 1519 years is 1.14%. […] 15% of children with sleep apnea have tonsillar hypertrophy.

• #33 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  15% of children with sleep apnea have adenoid hypertrophy. […] 1359% of children with sleep apnea are obese. […] Around 16% of children with craniofacial anomalies have sleep apnea. […] 40% of children with neuromuscular disorders have childhood sleep apnea. […] The prevalence of sleep apnea in children with down syndrome is 5376% compared to children without down syndrome, who have disease prevalence of 15%. […] The prevalence of sleep apnea in children with PWS is 57%. […] The prevalence of sleep apnea in children with AS is 2080%. […] Clinical manifestations for childhood sleep apnea include abnormal breathing during sleep, frequent awakenings or restlessness, frequent nightmares, nocturnal enuresis, difficulty getting up in the morning, excessive daytime sleepiness (EDS), daytime mouth breathing, abnormal sleep patterns, non-rapid eye movement (NREM) parasomnias, ADHD-like syndrome, and cognitive and neuropsychological conditions.

• #34 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  15% of children with sleep apnea have adenoid hypertrophy. […] 1359% of children with sleep apnea are obese. […] Around 16% of children with craniofacial anomalies have sleep apnea. […] 40% of children with neuromuscular disorders have childhood sleep apnea. […] The prevalence of sleep apnea in children with down syndrome is 5376% compared to children without down syndrome, who have disease prevalence of 15%. […] The prevalence of sleep apnea in children with PWS is 57%. […] The prevalence of sleep apnea in children with AS is 2080%. […] Clinical manifestations for childhood sleep apnea include abnormal breathing during sleep, frequent awakenings or restlessness, frequent nightmares, nocturnal enuresis, difficulty getting up in the morning, excessive daytime sleepiness (EDS), daytime mouth breathing, abnormal sleep patterns, non-rapid eye movement (NREM) parasomnias, ADHD-like syndrome, and cognitive and neuropsychological conditions.

• #35 Childhood Sleep Apnea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1004104-overview

  Epidemiology […] In nonobese and otherwise healthy children younger than 8 years, the prevalence of obstructive sleep apnea is estimated to be 1-3%. Habitual snoring is common during childhood and affects approximately 10% of children aged 2-8 years; the frequency decreases after age 9-10 years. Obesity confers 4-fold to 5-fold added risk for sleep-disordered breathing. In children and adolescents with coexisting medical conditions such as trisomy 21, the prevalence of obstructive sleep apnea may be as high as 80%. […] In the United Kingdom, approximately 1.75-2.25% of children aged 4-5 years are thought to have obstructive sleep apnea. Unfortunately, very few epidemiologic studies of childhood obstructive sleep apnea are available. […] Racial distribution […] Obstructive sleep apnea occurs more commonly among Black and Hispanic individuals than among White adults and children. In patients younger than 18 years, Blacks are 3.5 times more likely to develop obstructive sleep apnea than Whites. […] The high frequency of obstructive sleep apnea in adult Asian populations indicates that the anthropometric characteristics of the craniofacial structures in this racial group also predispose to higher obstructive sleep apnea rates in children. The frequency of obstructive sleep apnea in Hispanic children is equal to that of White children.

• #36 Pediatric sleep disordered breathing: a narrative review – Narayanasamy – Pediatric Medicine

  https://pm.amegroups.org/article/view/5050/html

  Pediatric sleep disordered breathing is a spectrum of ventilatory disorders associated with multisystem complications. This narrative review aimed to discuss the impact of obstructive sleep apnea (OSA) in pediatric patients, the presentation and phenotypic variations, sleep disordered breathing in special populations, screening for suspected sleep apnea, diagnosis and management of pediatric OSA. […] OSA is a multisystem disorder associated with various short term and long term complications. There are numerous challenges with screening and diagnosis which leaves high number of undiagnosed OSA. […] Prevalence of pediatric OSA varied between 15% depending on the population and age group studied and the prevalence of habitual snoring up to 27.5% depending on the study and definition used. The prevalence is significantly higher in obese children, patients with down syndrome, cerebral palsy, prematurity and craniofacial abnormalities. The prevalence is reported to be four to five-fold higher in obese children. Based on PSG in a large cohort of patients with down syndrome, the prevalence of OSA is reported to be 66%.

• #37

  https://medicaljournalssweden.se/actaodontologica/article/view/41385

  132 participants were diagnosed with OSA, and 55 were classified as no OSA (29.41%). […] Those overweight or obese were 4.97 times more likely to have OSA than those with normal weight (P = 0.005). […] Significantly increased OSA-related risk factors among overweight/obese children and adolescents and among those who had a parental/self-report of loud snoring were found. […] Epidemiology of pediatric obstructive sleep apnea.

• #38 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  The rise in the incidence of obesity in children and adolescents is leading to an epidemiological transition of obstructive SDB from the classic phenotype to the obese adult phenotype, with a peak incidence in adolescence. […] The prevalence of OSA in children with Down syndrome is very high compared to that in the general population (range, 31–79%), due to particular craniofacial features, adenotonsillar hypertrophy, hypotonia, and obesity. […] The prevalence of SDB in patients with neuromuscular disorders depends on the type of disease and the diagnostic criteria used.

• #39 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  The rise in the incidence of obesity in children and adolescents is leading to an epidemiological transition of obstructive SDB from the classic phenotype to the obese adult phenotype, with a peak incidence in adolescence. […] The prevalence of OSA in children with Down syndrome is very high compared to that in the general population (range, 31–79%), due to particular craniofacial features, adenotonsillar hypertrophy, hypotonia, and obesity. […] The prevalence of SDB in patients with neuromuscular disorders depends on the type of disease and the diagnostic criteria used.

• #40 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  15% of children with sleep apnea have adenoid hypertrophy. […] 1359% of children with sleep apnea are obese. […] Around 16% of children with craniofacial anomalies have sleep apnea. […] 40% of children with neuromuscular disorders have childhood sleep apnea. […] The prevalence of sleep apnea in children with down syndrome is 5376% compared to children without down syndrome, who have disease prevalence of 15%. […] The prevalence of sleep apnea in children with PWS is 57%. […] The prevalence of sleep apnea in children with AS is 2080%. […] Clinical manifestations for childhood sleep apnea include abnormal breathing during sleep, frequent awakenings or restlessness, frequent nightmares, nocturnal enuresis, difficulty getting up in the morning, excessive daytime sleepiness (EDS), daytime mouth breathing, abnormal sleep patterns, non-rapid eye movement (NREM) parasomnias, ADHD-like syndrome, and cognitive and neuropsychological conditions.

• #41 Pediatric sleep disordered breathing: a narrative review – Narayanasamy – Pediatric Medicine

  https://pm.amegroups.org/article/view/5050/html

  Pediatric sleep disordered breathing is a spectrum of ventilatory disorders associated with multisystem complications. This narrative review aimed to discuss the impact of obstructive sleep apnea (OSA) in pediatric patients, the presentation and phenotypic variations, sleep disordered breathing in special populations, screening for suspected sleep apnea, diagnosis and management of pediatric OSA. […] OSA is a multisystem disorder associated with various short term and long term complications. There are numerous challenges with screening and diagnosis which leaves high number of undiagnosed OSA. […] Prevalence of pediatric OSA varied between 15% depending on the population and age group studied and the prevalence of habitual snoring up to 27.5% depending on the study and definition used. The prevalence is significantly higher in obese children, patients with down syndrome, cerebral palsy, prematurity and craniofacial abnormalities. The prevalence is reported to be four to five-fold higher in obese children. Based on PSG in a large cohort of patients with down syndrome, the prevalence of OSA is reported to be 66%.

• #42 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  15% of children with sleep apnea have adenoid hypertrophy. […] 1359% of children with sleep apnea are obese. […] Around 16% of children with craniofacial anomalies have sleep apnea. […] 40% of children with neuromuscular disorders have childhood sleep apnea. […] The prevalence of sleep apnea in children with down syndrome is 5376% compared to children without down syndrome, who have disease prevalence of 15%. […] The prevalence of sleep apnea in children with PWS is 57%. […] The prevalence of sleep apnea in children with AS is 2080%. […] Clinical manifestations for childhood sleep apnea include abnormal breathing during sleep, frequent awakenings or restlessness, frequent nightmares, nocturnal enuresis, difficulty getting up in the morning, excessive daytime sleepiness (EDS), daytime mouth breathing, abnormal sleep patterns, non-rapid eye movement (NREM) parasomnias, ADHD-like syndrome, and cognitive and neuropsychological conditions.

• #43 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  15% of children with sleep apnea have adenoid hypertrophy. […] 1359% of children with sleep apnea are obese. […] Around 16% of children with craniofacial anomalies have sleep apnea. […] 40% of children with neuromuscular disorders have childhood sleep apnea. […] The prevalence of sleep apnea in children with down syndrome is 5376% compared to children without down syndrome, who have disease prevalence of 15%. […] The prevalence of sleep apnea in children with PWS is 57%. […] The prevalence of sleep apnea in children with AS is 2080%. […] Clinical manifestations for childhood sleep apnea include abnormal breathing during sleep, frequent awakenings or restlessness, frequent nightmares, nocturnal enuresis, difficulty getting up in the morning, excessive daytime sleepiness (EDS), daytime mouth breathing, abnormal sleep patterns, non-rapid eye movement (NREM) parasomnias, ADHD-like syndrome, and cognitive and neuropsychological conditions.

• #44 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  15% of children with sleep apnea have adenoid hypertrophy. […] 1359% of children with sleep apnea are obese. […] Around 16% of children with craniofacial anomalies have sleep apnea. […] 40% of children with neuromuscular disorders have childhood sleep apnea. […] The prevalence of sleep apnea in children with down syndrome is 5376% compared to children without down syndrome, who have disease prevalence of 15%. […] The prevalence of sleep apnea in children with PWS is 57%. […] The prevalence of sleep apnea in children with AS is 2080%. […] Clinical manifestations for childhood sleep apnea include abnormal breathing during sleep, frequent awakenings or restlessness, frequent nightmares, nocturnal enuresis, difficulty getting up in the morning, excessive daytime sleepiness (EDS), daytime mouth breathing, abnormal sleep patterns, non-rapid eye movement (NREM) parasomnias, ADHD-like syndrome, and cognitive and neuropsychological conditions.

• #45 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  15% of children with sleep apnea have adenoid hypertrophy. […] 1359% of children with sleep apnea are obese. […] Around 16% of children with craniofacial anomalies have sleep apnea. […] 40% of children with neuromuscular disorders have childhood sleep apnea. […] The prevalence of sleep apnea in children with down syndrome is 5376% compared to children without down syndrome, who have disease prevalence of 15%. […] The prevalence of sleep apnea in children with PWS is 57%. […] The prevalence of sleep apnea in children with AS is 2080%. […] Clinical manifestations for childhood sleep apnea include abnormal breathing during sleep, frequent awakenings or restlessness, frequent nightmares, nocturnal enuresis, difficulty getting up in the morning, excessive daytime sleepiness (EDS), daytime mouth breathing, abnormal sleep patterns, non-rapid eye movement (NREM) parasomnias, ADHD-like syndrome, and cognitive and neuropsychological conditions.

• #46 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #47 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #48 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #49 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #50 Obstructive Sleep Apnea (OSA) in Children – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/sleep-apnea/obstructive-sleep-apnea-osa-in-children

  Obstructive sleep apnea (OSA) is episodes of partial or complete closure of the upper airway that occur during sleep and lead to breathing cessation. […] The prevalence of obstructive sleep apnea in children is about 2% (1). The condition is underdiagnosed and can lead to serious sequelae. […] Risk factors for obstructive sleep apnea in children include the following: Obesity (the most common cause), Enlarged tonsils or adenoids, Allergic rhinitis (ie, causing significant nasal congestion), Craniofacial abnormalities (eg, micrognathia, retrognathia, midfacial hypoplasia, excessively angled skull base), Certain medications (eg, sedatives, opioids), Mucopolysaccharidoses, Disorders causing hypotonia or hypertonia (eg, Down syndrome, cerebral palsy, muscular dystrophies), Possibly genetic factors (eg, congenital central hypoventilation disorders that can include both obstructive and central sleep apneas, and Prader-Willi syndrome and others).

• #51 Multifaceted Landscape of Pediatric Obstructive Sleep Apnea | NSS

  https://www.dovepress.com/exploring-the-multifaceted-landscape-of-pediatric-obstructive-sleep-ap-peer-reviewed-fulltext-article-NSS

  Pediatric obstructive sleep apnea (OSA) is a multifaceted disorder marked by recurrent upper airway obstruction during sleep, often coexisting with various medical conditions. This study, aimed to comprehensively analyze the Multifaceted Landscape of Pediatric Insights into Prevalence, Severity, and Coexisting Conditions. With a sample of 1928 participants, our study sought to determine the prevalence, severity, and associations between OSA and diverse conditions. […] High OSA prevalence was evident across age groups, with severity peaking between 3 to 12 years. Among the participants, coexisting conditions included allergic rhinitis (59.6%), tonsillar hypertrophy (49.7%), adenoid hypertrophy (28.4%), and obesity (15.3%). […] The prevalence of pediatric OSA has been steadily increasing over the past few decades, reaching a level of concern worldwide. Estimations suggest that OSA affects approximately 5.7% of children, with higher rates reported in specific populations, such as those with obesity or allergic disorders. However, the true prevalence might be underestimated due to underdiagnosis or misdiagnosis, as symptoms of OSA in children can be subtle and nonspecific.

• #52 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  A reasonable preponderance of evidence now suggests that SDB is more common among boys than girls, and among children who are heavier than others, with emerging data to suggest a higher prevalence among African Americans. […] We conclude by outlining specific future research needs in the epidemiology of pediatric SDB. […] Accurate identification of the prevalence of primary snoring and obstructive sleep apnea (OSA) in the pediatric population is critical from both a clinical and research perspective. […] For researchers, recognizing differences in the prevalence of the disorder between population subgroups may inform the understanding of etiology and guide future investigation. […] The description of sleep-disordered breathing (SDB) prevalence is fraught with difficulty due to a variety of methodologic issues, most of which involve heterogeneity in diagnostic criteria.

• #53 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  The same meta-analysis reports a prevalence of habitual snoring of 7.45%, including some studies which documented a prevalence as high as 35% or as low as 3%. […] The description of pediatric OSA epidemiology and, in general, obstructive SDB is critical, due to a plethora of methodologic issues, most of which involve heterogeneity in diagnostic criteria, children’s age, and presence of medical and neurologic morbidities. […] The majority of SDB in children is obstructive and includes a spectrum of conditions, ranging from habitual snoring (prevalence, 7.45%; range, 3–35%) to OSA (prevalence, 2–5%; range, 0.1–13%). […] Adenotonsillar hypertrophy (classic phenotype) is the most common risk factor for obstructive SDB in healthy children, with a peak incidence between 2 and 8 years of age.

• #54 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Epidemiologic studies have rarely examined obstructive hypoventilation, which remains unassessed by the ubiquitous apneahypopnea index (AHI) and inadequately assessed by most measures of oxygen desaturation. […] Therefore, in summary, estimates of childhood OSA prevalence may be artificially low because research has often excluded both UARS and obstructive hypoventilation from assessments that were performed. […] We performed a separate literature review seeking to identify studies describing the persistence, remittance, and incidence of SDB cases. […] One might hypothesize this to be the case if SDB is truly more common among children of higher weight status, given that the prevalence of overweight among children has increased dramatically over the past several decades. […] Additional studies are needed with large sample sizes that will allow more thorough investigation of the following: (1) the sensitivity and specificity of symptoms for a PSG-confirmed diagnosis of OSA, (2) the natural history of PSG-confirmed OSA if not treated, (3) the incidence rates at which new cases of OSA develop across childhood, (4) outcomes that can support evidence-based PSG and alternative diagnostic criteria, and (5) the existence and etiology of differences in SDB prevalence based on sex and weight (which are probably significant) and race and age (which may or may not be significant). […] The morbidity associated with SDB is only beginning to be understood and widely appreciated. Further research into the epidemiology of childhood SDB and its consequences could play a key role in improving efforts to systematically diagnose and treat this condition.

• #55 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Epidemiologic studies have rarely examined obstructive hypoventilation, which remains unassessed by the ubiquitous apneahypopnea index (AHI) and inadequately assessed by most measures of oxygen desaturation. […] Therefore, in summary, estimates of childhood OSA prevalence may be artificially low because research has often excluded both UARS and obstructive hypoventilation from assessments that were performed. […] We performed a separate literature review seeking to identify studies describing the persistence, remittance, and incidence of SDB cases. […] One might hypothesize this to be the case if SDB is truly more common among children of higher weight status, given that the prevalence of overweight among children has increased dramatically over the past several decades. […] Additional studies are needed with large sample sizes that will allow more thorough investigation of the following: (1) the sensitivity and specificity of symptoms for a PSG-confirmed diagnosis of OSA, (2) the natural history of PSG-confirmed OSA if not treated, (3) the incidence rates at which new cases of OSA develop across childhood, (4) outcomes that can support evidence-based PSG and alternative diagnostic criteria, and (5) the existence and etiology of differences in SDB prevalence based on sex and weight (which are probably significant) and race and age (which may or may not be significant). […] The morbidity associated with SDB is only beginning to be understood and widely appreciated. Further research into the epidemiology of childhood SDB and its consequences could play a key role in improving efforts to systematically diagnose and treat this condition.

• #56 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  About 90% of children are underdiagnosed for sleep apnea. […] Studies have shown that Black children have a higher odds of developing sleep apnea and often have a 20% increase in the severity of sleep apnea. […] The prevalence of sleep apnea in Black children is 47.1%, the prevalence of sleep apnea in Hispanic children in 12.5%, and the prevalence of sleep apnea in White children is 40.4%. […] The prevalence of sleep apnea for children between the ages 04 years is 0.66%, the prevalence of sleep apnea for children between the ages of 59 years is 1.37%, the prevalence of sleep apnea for children between the ages of 1014 years is 1.56%, and the prevalence of sleep apnea for children between the ages of 1519 years is 1.14%. […] 15% of children with sleep apnea have tonsillar hypertrophy.

• #57 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  Sleep disordered breathing encompasses a wide range of upper airway disorders from primary snoring (PS) to obstructive sleep apnea (OSA). OSA has become recognized as one of the most common, underdiagnosed chronic diseases. People of all ages are affected with OSA. Recently studies have shown increased numbers among pediatric and adolescent populations. The prevalence of obstructive sleep apnea (OSA) in children is estimated to be 1% to 3%, while primary snoring occurs in 3% to 12% of the pediatric population. […] Many studies have been conducted to identify adverse effects of sleep disorders, yet few studies have examined how health care providers may identify and treat sleep disorders. […] However, many potential sleep disorders in children are unrecognized and underreported, and overall the condition is under-diagnosed.

• #58 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  Sleep disordered breathing encompasses a wide range of upper airway disorders from primary snoring (PS) to obstructive sleep apnea (OSA). OSA has become recognized as one of the most common, underdiagnosed chronic diseases. People of all ages are affected with OSA. Recently studies have shown increased numbers among pediatric and adolescent populations. The prevalence of obstructive sleep apnea (OSA) in children is estimated to be 1% to 3%, while primary snoring occurs in 3% to 12% of the pediatric population. […] Many studies have been conducted to identify adverse effects of sleep disorders, yet few studies have examined how health care providers may identify and treat sleep disorders. […] However, many potential sleep disorders in children are unrecognized and underreported, and overall the condition is under-diagnosed.

• #59 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  The risk of postoperative respiratory complications among the pediatric population ranges from 0 to 1.3%; however, for children with OSA, the rates have been reported to be 16% to 27%. […] While polysomnography (PSG) remains the gold standard for diagnosing OSA, there are many challenges due to the limited number of sleep laboratories and the high cost of performing a PSG on each child who snores and who may be at risk. […] This review documented that few standardized screening tools exist thus far to determine risk for OSA in children. Pediatric dentists and anesthesiologists alike would benefit from a standard screening tool, similar to the STOP-Bang, to determine if OSA may exist in potential sedation and anesthesia pediatric patients. […] Currently there is no screening tool available to pediatric dentists to aid in recognizing OSA during the preoperative appointment or to help direct specialty consultation for patients undergoing minimal and moderate oral conscious sedation.

• #60 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  The literature indicates that less than half of children with OSA symptoms actually have the syndrome. As a result, screening for OSA is challenging and causes many children to go undiagnosed. Presently, pediatric OSA is under-diagnosed and thus undertreated because of the high cost to test for OSA and the limited number of pediatric sleep laboratories. Consequently screening for OSA has become essential. […] The results of the current study found a clinically significant correlation between the proposed STOP-Bang scale and AHI. However, only one individual component was strongly related to AHI. This suggests that certain variables that present together in a single individual may predispose that person to OSA more than individual parameters. […] The purpose of the study was to develop a concise and easy-to-use questionnaire as a screening tool to aid in the recognition of OSA in pediatric patients. The screening scale proposed (PM-STOP-Bang) proved to be predictive of pediatric OSA.

• #61 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  The risk of postoperative respiratory complications among the pediatric population ranges from 0 to 1.3%; however, for children with OSA, the rates have been reported to be 16% to 27%. […] While polysomnography (PSG) remains the gold standard for diagnosing OSA, there are many challenges due to the limited number of sleep laboratories and the high cost of performing a PSG on each child who snores and who may be at risk. […] This review documented that few standardized screening tools exist thus far to determine risk for OSA in children. Pediatric dentists and anesthesiologists alike would benefit from a standard screening tool, similar to the STOP-Bang, to determine if OSA may exist in potential sedation and anesthesia pediatric patients. […] Currently there is no screening tool available to pediatric dentists to aid in recognizing OSA during the preoperative appointment or to help direct specialty consultation for patients undergoing minimal and moderate oral conscious sedation.

• #62 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  The literature indicates that less than half of children with OSA symptoms actually have the syndrome. As a result, screening for OSA is challenging and causes many children to go undiagnosed. Presently, pediatric OSA is under-diagnosed and thus undertreated because of the high cost to test for OSA and the limited number of pediatric sleep laboratories. Consequently screening for OSA has become essential. […] The results of the current study found a clinically significant correlation between the proposed STOP-Bang scale and AHI. However, only one individual component was strongly related to AHI. This suggests that certain variables that present together in a single individual may predispose that person to OSA more than individual parameters. […] The purpose of the study was to develop a concise and easy-to-use questionnaire as a screening tool to aid in the recognition of OSA in pediatric patients. The screening scale proposed (PM-STOP-Bang) proved to be predictive of pediatric OSA.

• #63 Obstructive Sleep Apnea in Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0301/p1147.html

  Obstructive sleep-disordered breathing is common in children. From 3 percent to 12 percent of children snore, while obstructive sleep apnea syndrome affects 1 percent to 10 percent of children. […] The estimated prevalence of snoring in children is 3 to 12 percent, while OSA affects 1 to 10 percent. […] Sleep-disordered breathing in children is a timely public health concern, given the increasing rates of obesity and hyperactivity in this population. […] The role of polysomnography in the diagnosis of childhood sleep-disordered breathing remains controversial. Although polysomnography is the current gold standard, authorities cite the lack of reliable sleep laboratories for children, excess cost, and lack of consensus on interpretation of polysomnograms as reasons it is not required for diagnosis. […] Adenotonsillectomy remains the treatment of choice for most children with a strong clinical history of OSA or with OSA documented by polysomnography.

• #64 Polysomnographic Characteristics of Snoring Children: A Familial Study of Obstructive Sleep Apnea Syndrome | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-polysomnographic-characteristics-snoring-children-a-articulo-S0300289620300284

  Obstructive sleep apnea (OSA) is a prevalent disorder that affects both adults and children. This disorder is characterized by episodic upper airway obstruction during sleep, resulting in recurrent episodes of intermittent hypoxia and repeated arousals. Clinically, OSA is characterized by snoring, daytime sleepiness and an impairment of quality of life and has been implicated as a risk factor for the development of cardiovascular and metabolic outcomes. In addition, a broad spectrum of adverse consequences in the development during childhood has been associated with OSA, including cognitive and behavioral problems, and a decrease in the quality of life. […] The prevalence and clinical relevance of OSA among children has increased over the past decade. Although adenotonsillar hypertrophy is the major contributor to the pathophysiology of OSA in the pediatric age, environmental and genetic factors potentially interact in the pathogenesis of pediatric OSA. Nevertheless, there are limited data regarding the identification of risk factors which may assist in the assessment of susceptible pediatric population. The identification of specific phenotypes including individual, familial and environmental variables could help in the establishment of diagnostic algorithms and early therapeutic strategies. Available evidence suggests a familial basis for OSA.

• #65 Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors

  https://www.mdpi.com/2227-9067/10/6/955

  The rise in the incidence of obesity in children and adolescents is leading to an epidemiological transition of obstructive SDB from the classic phenotype to the obese adult phenotype, with a peak incidence in adolescence. […] The prevalence of OSA in children with Down syndrome is very high compared to that in the general population (range, 31–79%), due to particular craniofacial features, adenotonsillar hypertrophy, hypotonia, and obesity. […] The prevalence of SDB in patients with neuromuscular disorders depends on the type of disease and the diagnostic criteria used.

• #66 Childhood Sleep Apnea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1004104-overview

  Epidemiology […] In nonobese and otherwise healthy children younger than 8 years, the prevalence of obstructive sleep apnea is estimated to be 1-3%. Habitual snoring is common during childhood and affects approximately 10% of children aged 2-8 years; the frequency decreases after age 9-10 years. Obesity confers 4-fold to 5-fold added risk for sleep-disordered breathing. In children and adolescents with coexisting medical conditions such as trisomy 21, the prevalence of obstructive sleep apnea may be as high as 80%. […] In the United Kingdom, approximately 1.75-2.25% of children aged 4-5 years are thought to have obstructive sleep apnea. Unfortunately, very few epidemiologic studies of childhood obstructive sleep apnea are available. […] Racial distribution […] Obstructive sleep apnea occurs more commonly among Black and Hispanic individuals than among White adults and children. In patients younger than 18 years, Blacks are 3.5 times more likely to develop obstructive sleep apnea than Whites. […] The high frequency of obstructive sleep apnea in adult Asian populations indicates that the anthropometric characteristics of the craniofacial structures in this racial group also predispose to higher obstructive sleep apnea rates in children. The frequency of obstructive sleep apnea in Hispanic children is equal to that of White children.

• #67 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Epidemiologic studies have rarely examined obstructive hypoventilation, which remains unassessed by the ubiquitous apneahypopnea index (AHI) and inadequately assessed by most measures of oxygen desaturation. […] Therefore, in summary, estimates of childhood OSA prevalence may be artificially low because research has often excluded both UARS and obstructive hypoventilation from assessments that were performed. […] We performed a separate literature review seeking to identify studies describing the persistence, remittance, and incidence of SDB cases. […] One might hypothesize this to be the case if SDB is truly more common among children of higher weight status, given that the prevalence of overweight among children has increased dramatically over the past several decades. […] Additional studies are needed with large sample sizes that will allow more thorough investigation of the following: (1) the sensitivity and specificity of symptoms for a PSG-confirmed diagnosis of OSA, (2) the natural history of PSG-confirmed OSA if not treated, (3) the incidence rates at which new cases of OSA develop across childhood, (4) outcomes that can support evidence-based PSG and alternative diagnostic criteria, and (5) the existence and etiology of differences in SDB prevalence based on sex and weight (which are probably significant) and race and age (which may or may not be significant). […] The morbidity associated with SDB is only beginning to be understood and widely appreciated. Further research into the epidemiology of childhood SDB and its consequences could play a key role in improving efforts to systematically diagnose and treat this condition.

• #68 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  If left untreated, pediatric OSA can have serious morbidities and long-term complications. Sustained hypoxia can increase pulmonary vasoconstriction and lead to pulmonary hypertension and right heart failure at an early age. Cognitive dysfunction, impaired learning, and poor school performance are associated with undiagnosed and untreated pediatric OSA. Additionally, increased work of breathing can be associated with failure to thrive seen in younger populations.[2]

• #69 Pediatric sleep disordered breathing: a narrative review – Narayanasamy – Pediatric Medicine

  https://pm.amegroups.org/article/view/5050/html

  Early diagnosis and treatment of pediatric OSA is important to minimize the risk of development of the above-mentioned complications. […] Pediatric SDB is a spectrum and OSA is the most severe variant with a prevalence of up to 4% or higher in children. There are numerous challenges with screening and diagnosis which leaves high number of undiagnosed OSA. The approach to a child with suspected or confirmed OSA presenting for perioperative care is summarized.

• #70 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  If left untreated, pediatric OSA can have serious morbidities and long-term complications. Sustained hypoxia can increase pulmonary vasoconstriction and lead to pulmonary hypertension and right heart failure at an early age. Cognitive dysfunction, impaired learning, and poor school performance are associated with undiagnosed and untreated pediatric OSA. Additionally, increased work of breathing can be associated with failure to thrive seen in younger populations.[2]

• #71 Sleep apnoea in the child

  https://www.racgp.org.au/afp/2015/june/sleep-apnoea-in-the-child

  Obstructive sleep apnoea (OSA) is a condition causing repetitive episodes of upper airway obstruction during sleep, leading to hypoxia and/or sleep disturbance. OSA affects 15% of children and has important implications for learning, behaviour and cardiovascular health. […] The condition affects 15% of children, and peaks in the pre-school years. […] The most common cause of OSA in childhood is enlargement of the tonsils and adenoids. […] OSA is associated with increases in blood pressure during sleep and structural changes, such as increased left and right ventricular wall thickness, evident on echocardiography. […] The relationship of OSA with impairments in memory, attention, learning and behaviour has been recognised for many years. […] Symptoms of OSA should be sought in any child with enlarged tonsils and/or disturbed or unrefreshing sleep.

• #72 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  If left untreated, pediatric OSA can have serious morbidities and long-term complications. Sustained hypoxia can increase pulmonary vasoconstriction and lead to pulmonary hypertension and right heart failure at an early age. Cognitive dysfunction, impaired learning, and poor school performance are associated with undiagnosed and untreated pediatric OSA. Additionally, increased work of breathing can be associated with failure to thrive seen in younger populations.[2]

• #73 Sleep apnoea in the child

  https://www.racgp.org.au/afp/2015/june/sleep-apnoea-in-the-child

  Obstructive sleep apnoea (OSA) is a condition causing repetitive episodes of upper airway obstruction during sleep, leading to hypoxia and/or sleep disturbance. OSA affects 15% of children and has important implications for learning, behaviour and cardiovascular health. […] The condition affects 15% of children, and peaks in the pre-school years. […] The most common cause of OSA in childhood is enlargement of the tonsils and adenoids. […] OSA is associated with increases in blood pressure during sleep and structural changes, such as increased left and right ventricular wall thickness, evident on echocardiography. […] The relationship of OSA with impairments in memory, attention, learning and behaviour has been recognised for many years. […] Symptoms of OSA should be sought in any child with enlarged tonsils and/or disturbed or unrefreshing sleep.

• #74 Prevalence of childhood obstructive sleep apnea syndrome and its role in daytime sleepiness | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204409

  Mean prevalence of mild to severe p-OSAS and severe p-OSAS in children across all grade levels was 9.5% and 1.6%, respectively. […] The prevalence of OSAS and other sleep-related breathing disorders among children is estimated to be 15.8% by definitive diagnostic surveys using objective indicators such as polysomnography or pulse oximetry and 4-11% based on questionnaire surveys of parents. […] p-OSAS may be an independent factor influencing daytime sleepiness in school-age children. Loud snoring and breathing pauses could be clinical markers for children with severe daytime sleepiness. […] The results revealed that independent of short sleep duration, presence of p-OSAS defined based on the presence of loud snoring, snorts and gasps, or breathing pauses was significantly correlated with daytime sleepiness in children.

• #75 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  If left untreated, pediatric OSA can have serious morbidities and long-term complications. Sustained hypoxia can increase pulmonary vasoconstriction and lead to pulmonary hypertension and right heart failure at an early age. Cognitive dysfunction, impaired learning, and poor school performance are associated with undiagnosed and untreated pediatric OSA. Additionally, increased work of breathing can be associated with failure to thrive seen in younger populations.[2]

• #76 Obstructive Sleep Apnea in Pediatric Patients | RT

  https://respiratory-therapy.com/disorders-diseases/sleep-medicine/obstructive-sleep-apnea-in-pediatric-patients/

  Obstructive sleep apnea (OSA) is underdiagnosed in infants and children. […] More than 2 million children in the United States have OSA or other debilitating sleep disorders, yet only 20% of pediatricians screen for these problems. […] OSA lies further along the severity continuum than UARS and has an incidence, among children, of 1% to 3%. […] The clinical consequences of OSA are the direct result of the disorders two fundamental abnormalities. […] The clinical consequences of disrupted sleep architecture and hypoxemia as a result of SDB in children are becoming defined in the pediatric population. […] Poor growth is a common complication of childhood OSA; early reports cited the prevalence of failure to thrive as being as much as 50%. […] There are many predisposing factors for OSA.

• #77 Pediatric obstructive sleep apnea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/symptoms-causes/syc-20376196

  Pediatric obstructive sleep apnea is a condition in which a child’s breathing is partly or completely blocked during sleep. […] Obstructive sleep apnea can look different in children than it does in adults. […] The main risk factor for pediatric obstructive sleep apnea is enlarged tonsils and adenoids, especially in younger children. […] Without treatment, pediatric obstructive sleep apnea can lead to other health conditions called complications. […] Rarely, pediatric obstructive sleep apnea can cause infants and young children not to grow as much as those who don’t have the condition. […] Children who don’t receive treatment also may have a higher risk of later complications such as high blood pressure, high cholesterol, and a higher than typical blood sugar level that raises the risk of diabetes.

• #78 Pediatric sleep disordered breathing: a narrative review – Narayanasamy – Pediatric Medicine

  https://pm.amegroups.org/article/view/5050/html

  Early diagnosis and treatment of pediatric OSA is important to minimize the risk of development of the above-mentioned complications. […] Pediatric SDB is a spectrum and OSA is the most severe variant with a prevalence of up to 4% or higher in children. There are numerous challenges with screening and diagnosis which leaves high number of undiagnosed OSA. The approach to a child with suspected or confirmed OSA presenting for perioperative care is summarized.

• #79 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #80 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  The incidence of pediatric OSA peaks between 2 to 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway in this age group. Risk factors for early-onset OSA include prematurity, Down syndrome, African American race, and daycare attendance. The severity can be increased in those with obesity, tobacco exposure, and reduced family income. Boys are at an increased risk after puberty, but the prepubertal risk is equal among boys and girls.[3] […] Patient populations that are at a higher risk of having OSA have an increased risk of neurocognitive disability later in life compared to their peers if OSA is left untreated.[5] If identified and managed promptly, patients will not suffer long-term consequences or complications of pediatric OSA.[2]

• #81 Obstructive Sleep Apnea in Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0301/p1147.html

  Obstructive sleep-disordered breathing is common in children. From 3 percent to 12 percent of children snore, while obstructive sleep apnea syndrome affects 1 percent to 10 percent of children. […] The estimated prevalence of snoring in children is 3 to 12 percent, while OSA affects 1 to 10 percent. […] Sleep-disordered breathing in children is a timely public health concern, given the increasing rates of obesity and hyperactivity in this population. […] The role of polysomnography in the diagnosis of childhood sleep-disordered breathing remains controversial. Although polysomnography is the current gold standard, authorities cite the lack of reliable sleep laboratories for children, excess cost, and lack of consensus on interpretation of polysomnograms as reasons it is not required for diagnosis. […] Adenotonsillectomy remains the treatment of choice for most children with a strong clinical history of OSA or with OSA documented by polysomnography.

• #82 Polysomnographic Characteristics of Snoring Children: A Familial Study of Obstructive Sleep Apnea Syndrome | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-polysomnographic-characteristics-snoring-children-a-articulo-S0300289620300284

  Obstructive sleep apnea (OSA) is a prevalent disorder that affects both adults and children. This disorder is characterized by episodic upper airway obstruction during sleep, resulting in recurrent episodes of intermittent hypoxia and repeated arousals. Clinically, OSA is characterized by snoring, daytime sleepiness and an impairment of quality of life and has been implicated as a risk factor for the development of cardiovascular and metabolic outcomes. In addition, a broad spectrum of adverse consequences in the development during childhood has been associated with OSA, including cognitive and behavioral problems, and a decrease in the quality of life. […] The prevalence and clinical relevance of OSA among children has increased over the past decade. Although adenotonsillar hypertrophy is the major contributor to the pathophysiology of OSA in the pediatric age, environmental and genetic factors potentially interact in the pathogenesis of pediatric OSA. Nevertheless, there are limited data regarding the identification of risk factors which may assist in the assessment of susceptible pediatric population. The identification of specific phenotypes including individual, familial and environmental variables could help in the establishment of diagnostic algorithms and early therapeutic strategies. Available evidence suggests a familial basis for OSA.

• #83 Polysomnographic Characteristics of Snoring Children: A Familial Study of Obstructive Sleep Apnea Syndrome | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-polysomnographic-characteristics-snoring-children-a-articulo-S0300289620300284

  The aim of the present study was to assess the potential influences of paternal and maternal presence of OSA in predicting the diagnosis and severity of OSA across snoring children referred to a sleep unit. […] Our findings suggest a high prevalence of OSA among the family members studied with an increased association of childhood OSA with paternal OSA. Prediction of OSA risk among children can be significantly improved by adding data on paternal OSA status. […] Overall, the odds of having moderate-severe OSA was more than 4 times higher among children with the father with OSA. There was no evidence of any statistical interaction between maternal and paternal OSA and its influence on OSA severity among the children studied. […] In summary, based on our data, the prediction of OSA risk among snoring children can be significantly improved by adding data on paternal OSA status. The high prevalence of familial OSA makes it important to characterize OSA phenotypes in childhood that may lead to a better diagnosis and treatment of this condition.

• #84 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  The risk of postoperative respiratory complications among the pediatric population ranges from 0 to 1.3%; however, for children with OSA, the rates have been reported to be 16% to 27%. […] While polysomnography (PSG) remains the gold standard for diagnosing OSA, there are many challenges due to the limited number of sleep laboratories and the high cost of performing a PSG on each child who snores and who may be at risk. […] This review documented that few standardized screening tools exist thus far to determine risk for OSA in children. Pediatric dentists and anesthesiologists alike would benefit from a standard screening tool, similar to the STOP-Bang, to determine if OSA may exist in potential sedation and anesthesia pediatric patients. […] Currently there is no screening tool available to pediatric dentists to aid in recognizing OSA during the preoperative appointment or to help direct specialty consultation for patients undergoing minimal and moderate oral conscious sedation.

• #85 Epidemiology of Childhood Sleep Apnea | IntechOpen

  https://www.intechopen.com/chapters/1164145

  Diagnosis criteria for childhood sleep apnea are factors used in medical practice to direct the care of young patients through the assessment of symptoms, signs, and tests. […] The assessment of severity is used to describe the intensity of sleep apnea cases in children. […] Screening is the application of tools used to detect potential disease occurrence in patients, who are without symptoms. […] To aid an efforts to relieve, prevent, and diagnose childhood sleep apnea, there needs to be more efforts to promote the commonality of the disease in children, to educate parents on identifying the symptoms, to explore new treatment options, and to promote the implementation of diagnostic testing for sleep apnea as a standard of care in pediatric patients.

• #86 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  Sleep disordered breathing encompasses a wide range of upper airway disorders from primary snoring (PS) to obstructive sleep apnea (OSA). OSA has become recognized as one of the most common, underdiagnosed chronic diseases. People of all ages are affected with OSA. Recently studies have shown increased numbers among pediatric and adolescent populations. The prevalence of obstructive sleep apnea (OSA) in children is estimated to be 1% to 3%, while primary snoring occurs in 3% to 12% of the pediatric population. […] Many studies have been conducted to identify adverse effects of sleep disorders, yet few studies have examined how health care providers may identify and treat sleep disorders. […] However, many potential sleep disorders in children are unrecognized and underreported, and overall the condition is under-diagnosed.

• #87 Reprinted Article 1, Issue 5.4

  https://aadsm.org/journal/reprinted_article_1_issue_54.php

  The literature indicates that less than half of children with OSA symptoms actually have the syndrome. As a result, screening for OSA is challenging and causes many children to go undiagnosed. Presently, pediatric OSA is under-diagnosed and thus undertreated because of the high cost to test for OSA and the limited number of pediatric sleep laboratories. Consequently screening for OSA has become essential. […] The results of the current study found a clinically significant correlation between the proposed STOP-Bang scale and AHI. However, only one individual component was strongly related to AHI. This suggests that certain variables that present together in a single individual may predispose that person to OSA more than individual parameters. […] The purpose of the study was to develop a concise and easy-to-use questionnaire as a screening tool to aid in the recognition of OSA in pediatric patients. The screening scale proposed (PM-STOP-Bang) proved to be predictive of pediatric OSA.

• #88 Epidemiology of Pediatric Obstructive Sleep Apnea

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2645255/

  Epidemiologic studies have rarely examined obstructive hypoventilation, which remains unassessed by the ubiquitous apneahypopnea index (AHI) and inadequately assessed by most measures of oxygen desaturation. […] Therefore, in summary, estimates of childhood OSA prevalence may be artificially low because research has often excluded both UARS and obstructive hypoventilation from assessments that were performed. […] We performed a separate literature review seeking to identify studies describing the persistence, remittance, and incidence of SDB cases. […] One might hypothesize this to be the case if SDB is truly more common among children of higher weight status, given that the prevalence of overweight among children has increased dramatically over the past several decades. […] Additional studies are needed with large sample sizes that will allow more thorough investigation of the following: (1) the sensitivity and specificity of symptoms for a PSG-confirmed diagnosis of OSA, (2) the natural history of PSG-confirmed OSA if not treated, (3) the incidence rates at which new cases of OSA develop across childhood, (4) outcomes that can support evidence-based PSG and alternative diagnostic criteria, and (5) the existence and etiology of differences in SDB prevalence based on sex and weight (which are probably significant) and race and age (which may or may not be significant). […] The morbidity associated with SDB is only beginning to be understood and widely appreciated. Further research into the epidemiology of childhood SDB and its consequences could play a key role in improving efforts to systematically diagnose and treat this condition.

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