Analysis of the Risk Factors Associated With Obstructive Sleep Apnea Syndrome in Chinese Children

Ling, Xiao; Su, Shuping; Jia, Longfei; Jiang, Ying; Shu, Yan; Ding, Ling

doi:10.3389/fped.2022.900216

Cited by 16 publications

(12 citation statements)

References 45 publications

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“…A high adenoid grade is a risk factor for AH complicated by OME. The higher the adenoid grade, the greater the respiratory tract obstruction and the more severe the OSA in pediatric patients (25). However, PSG monitoring data analysis in this study revealed no significant correlation between the AHI, OAI, diagnosis and severity of OSA, and the incidence of OME in pediatric patients with AH (P > 0.05).…”

Section: Mechanical Obstructioncontrasting

confidence: 67%

Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy

Chen

Yin²,

Chen³

et al. 2023

Front. Pediatr.

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ObjectiveAdenoid hypertrophy (AH) and otitis media with effusion (OME) are common pediatric otolaryngological diseases and often occur concurrently. The purpose of this study was to comprehensively analyze the factors that influence the occurrence of OME pediatric patients with AH.MethodsPatients younger than 12 years with AH, who were hospitalized for treatment at Beijing Tsinghua Changgung Hospital in Beijing, China, between March 2018 and February 2022 were enrolled. The patients were divided into an AH group and an AH + OME group based on the presence of OME. The authors collected the following clinical data for univariable analysis: sex; age; body mass index (BMI); comorbid nasal congestion/rhinorrhea, recurrent tonsillitis, or allergic rhinitis (AR); adenoid and tonsil grade; tonsillar hypertrophy; food/drug allergy; history of adenoidectomy and congenital diseases; breastfeeding status; preterm birth; exposure to environmental tobacco smoke (ETS); family history of adenotonsillectomy, otitis media, and AR; main data of polysomnography and oropharyngeal conditional pathogen culture data of some patients. Univariate analysis was performed as a basis for logistic regression analysis.ResultsA total of 511 children (329 boys and 182 girls) were included, their mean age was 5.37 ± 2.10 years. Of them, 407 (79.6%) were in the AH group and 104 (20.4%) in the AH + OME group. Univariate analysis revealed statistically significant differences in age, BMI, adenoid grade, AR, breastfeeding status, and ETS exposure between the two groups. Multivariate stepwise logistic regression analysis showed that age, adenoid grade, AR, breastfeeding status, and ETS influenced the occurrence of OME in pediatric patients with AH. The risk of OME decreased with increasing age. High adenoid grade, ETS exposure, and comorbid AR were risk factors for OME in pediatric patients with AH, but breastfeeding was a protective factor. The final analytical results of the oropharyngeal conditional pathogen culture data showed that Streptococcus pneumoniae positivity was associated with OME in AH.ConclusionThe pathogenesis of AH with OME is complex. Young age, high adenoid grade, ETS exposure, non-breastfed status, comorbid AR, and the presence of S. pneumoniae in the oropharynx are risk factors for OME in pediatric patients with AH.

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Section: Mechanical Obstructioncontrasting

confidence: 67%

Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy

Chen

Yin²,

Chen³

et al. 2023

Front. Pediatr.

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“…This result is similar to that reported from other authors ( 18 , 25 ). Li et al conducted a study on 1150 children and found that the size of the tonsils was an independent risk factor of OSA ( 26 ). The size of the tonsils increased by 25–50% could increase the risk of OSA by two times (OR = 2.0 and p = 0.036), the size of the tonsil increased 50–75% could increase the risk of OSA by five times (OR = 5.0 and p = 0.022), and if it increased by 75–100%, induced the risk of OSA by eight times (OR = 8.1 and p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of obstructive sleep apnea treatment by antileukotriene receptor and surgery therapy in children with adenotonsillar hypertrophy: A descriptive and cohort study

et al. 2022

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BackgroundPrevalence of obstructive sleep apnea (OSA) in children with adenotonsillar hypertrophy is high and related to the occlusion of the upper airway. The main treatments of OSA in these children is adenotonsillectomy. However, this intervention is an invasive method with a various success rate. Thus, the indications of tonsillectomy remain debatable and non-invasive treatment is still a potential choice in these patients.MethodsIt was a cross-sectional and interventional study. This study included children aged from 2 to 12 years-old who were diagnosed with OSA by respiratory polygraphy and had tonsillar hypertrophy with/without adenoid hypertrophy. All main data including age, gender, height, weight, body mass index (BMI), clinical symptoms, and medical history were recorded for analysis. Physical examination and endoscopy were done to evaluate the size of tonsillar and adenoid hypertrophy by using Brodsky and Likert classifications, respectively. The severity of OSA was done by using the classification of AHI severity for children.ResultsThere were 114 patients (2–12 years old) with a mean age of 5.5 ± 2.1 years included in the present study. The main reasons for consultations were snoring (96.7%), a pause of breathing (57.1%), an effort to breathe (36.8%), unrefreshing sleep (32%), doziness (28.2%), and hyperactivity (26.3%). There were 36% of subjects with tonsillar hypertrophy grade 1–2, 48.2% with grade 3, and 15.8% with grade 4 (Brodsky classification); among them, there were 46.5% of subjects with grades 1–2 of adenoid hypertrophy, 45.6% with grade 3, and 7.0% with grade 4 (Likert classification). The mean AHI was 12.6 ± 11.2 event/h. There was a significant correlation between the mean AHI and the level of tonsillar and adenoid hypertrophy severity (r = 0.7601 and r = 0.7903; p < 0.05 and p < 0.05, respectively). The improvement of clinical symptoms of study subjects was found in both groups treated with ALR (antileukotriene receptor) or ST (surgery therapy). The symptoms related to OSA at night including snoring, struggle to breathe, sleeping with the mouth open, and stopping breathing during sleep were significantly improved after treatment with ATR and with ST (p < 0.001 and p = 0.001, respectively). The mean AHI was significantly reduced in comparison with before treatment in study subjects treated with ALR (0.9 ± 1.0 vs. 3.9 ± 2.7 events/h; p = 0.001) or with ST (3.5 ± 1.4 vs. 23.4 ± 13.1 events/h; p < 0.001).ConclusionThe treatment of OSA due to adeno-tonsillar hypertrophy with ALR for moderate OSA or surgery for severe OSA might reduce the symptoms related to OSA at night and during the day.

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“…[ 15 ] AH causes nasal congestion, snoring, mouth breathing, and incomplete occlusal and maxillofacial development in children, seriously affecting their physical and mental health and quality of life. [ 16 ] Surgical removal of adenoids is the most direct treatment for AH. Although surgical resection can quickly eliminate symptoms, it still has complications such as anesthesia risk and bleeding, nasopharyngeal stenosis, reduced nasal resistance, [ 17 , 18 ] and even immune suppression.…”

Section: Discussionmentioning

confidence: 99%

Effect of oral Xiao-xian decoction combined with acupoint application therapy on pediatric adenoid hypertrophy: A randomized trial

Zhao

Wang

et al. 2023

Medicine

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Background: This study aimed to observe the clinical effects of Xiao-xian decoction combined with acupoint application therapy (AAT) for treating pediatric adenoid hypertrophy (AH). Methods: We randomly divided 93 AH children into 3 groups: AAT alone; Xiao-xian decoction + AAT; control: Montelukast oral therapy. All participants were treated for a month. We used the traditional Chinese medicine syndrome score to evaluate the clinical efficacy and the obstructive sleep apnea-18 scale to evaluate the quality of life. Results: The major symptoms (nasal congestion, open mouth breathing, snoring, and tongue image) and secondary symptoms of patients treated with Xiao-xian decoction + AAT significantly improved compared to before treatment. The pairwise comparison between groups showed that snoring, tongue, secondary symptoms, and total effective rate of the combined treatment group were better than the control and AAT alone. Additionally, the open-mouth breathing, quality of life, and recurrence rate did not differ after treatment. Conclusion: Oral Xiao-xian decoction combined with AAT significantly improved the symptoms and signs of nasal congestion, open-mouth breathing, snoring, tongue, and quality of life of AH children and may be used as a long-term treatment for AH.

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Analysis of the Risk Factors Associated With Obstructive Sleep Apnea Syndrome in Chinese Children

Cited by 16 publications

References 45 publications

Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy

Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy

Efficacy of obstructive sleep apnea treatment by antileukotriene receptor and surgery therapy in children with adenotonsillar hypertrophy: A descriptive and cohort study

Effect of oral Xiao-xian decoction combined with acupoint application therapy on pediatric adenoid hypertrophy: A randomized trial

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