Differences in Anthropometric and Clinical Features among Preschoolers, School-Age Children, and Adolescents with Obstructive Sleep Apnea—A Hospital-Based Study in Taiwan

Abstract

Pediatric obstructive sleep apnea (OSA) is associated with adverse health outcomes; however, little is known about the diversity of this population. This retrospective study aims to investigate age-related differences in the anthropometric and clinical features of this population. A total of 253 Taiwanese children (70 (27.7%) girls and 183 (72.3%) boys) with OSA were reviewed. Their median age, body mass index (BMI) z-score, and apnea-hypopnea index were 6.9 years, 0.87, and 9.5 events/h, respectively. The cohort was divided into three subgroups: ‘preschoolers’ (≥2 and <6 years), ‘school-age children’ (≥6 and <10 years), and ‘adolescents (≥10 and <18 years)’. The percentage of the male sex, BMI z-score, neck circumference, systolic blood pressure z-score, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio tended to increase with age. Adenoid grades tended to decrease with age. Overall, disease severity was independently correlated with neck circumference, tonsil size, and adenoid grade. Increased neck circumference and tonsillar hypertrophy were the most influential factors for younger children, whereas adenoidal hypertrophy became more important at an older age. In conclusion, gender prevalence ratio, anthropometric measures, and clinical features varied with age, and the pathogenic drivers were not necessarily the same as the aggravating ones.

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

“…The inclusion criteria were: (a) age range from 2 to 17 years; and (b) having standard polysomnography data at baseline. The exclusion criteria were: (a) craniofacial or neuromuscular disorders [ 25 ]; and (b) chronic inflammatory disorders such as asthma or autoimmune diseases [ 5 ]. In addition, patients without BP data and those without complete polysomnography data were not included for statistical analysis.…”

“…The prevalence of OSAS reaches a peak during preschool years due to adenotonsillar hypertrophy, which compromises the upper airway [ 4 ]. Risk factors for childhood OSA include increased neck circumference, tonsil size, adenoid grade, body mass index (BMI) z-score, and diastolic blood pressure (DBP) [ 5 ]. Although preschool-aged children with OSAS have less severe cardiovascular and neurocognitive problems [ 6 ], school-aged children with OSAS may have recognizable sequelae [ 7 ].…”

Screening Severe Obstructive Sleep Apnea in Children with Snoring

“…The optimal cut-off value of the ANR was 0.78 for predicting severe OSA with the largest AUC comparing with other single predictors. The ANR is significantly associated with age [ 64 ] and AHI [ 19 ]. Clinically, an ANR ≥ 0.73 may be considered indicative of pathological enlargement of the adenoids [ 65 ].…”

“…All 42 patients had a standard in-laboratory polysomnography before home sleep apnea tests [ 9 ]. A case-matched control design was adopted to reduce the confounding effects from variables known to be associated with OSA severity [ 19 ]. There were 23 children with severe OSA and 19 age-, sex-, and BMI-matched control children with non-severe OSA.…”

Adenoidektomi, Tonsillektomi ve Adenotonsillektomi Planlanan Pediatrik Hastalarda Ortalama Trombosit Hacmi, Nötrofil/Lenfosit Oranı, Trombosit/Lenfosit Oranı ve Erken Postoperatif Anestezi Komplikasyonları

“…[1,2] Tonsil boyutunun, okul öncesi ve okul çağındaki çocuklarda OSA şiddetinin bir öngörücüsü olduğu bildirildi. [3,4] Son zamanlarda yapılan çalışmalarda nötrofil/lenfosit oranı (NLO) ile trombosit/lenfosit oranının (TLO), sistemik inflamasyonun kolayca elde edilebilen ve hesaplanabilen önemli göstergeleri olduğu ortaya konuldu. [5,6] Nötrofil/lenfosit oranı ve TLO'nun kardiyovasküler hastalık, maligniteler ve kronik inflamatuvar hastalıklarda da prognozun bir göstergesi olduğu saptandı.…”