Obstructive sleep apnea in children aged 3 years and younger: Rate and risk factors

Abstract

Objective Undiagnosed and untreated obstructive sleep apnea (OSA) can predispose children to neurobehavioural consequences. However, there is a lack of data identifying rate of, and risk factors for, OSA in very young healthy children. The objective of this study was to determine the rate of OSA and identify risk factors associated with the presence and severity of OSA in children aged 3 years and younger. Methods This was a retrospective chart review of healthy children between 1 and 3 years old who had a baseline polysomnogram (PSG) between January 2012 and June 2017. Patient demographics, referral history, and PSG data were recorded. Results One hundred and thirteen children were referred for a PSG, of which 66 (58%) were diagnosed with OSA and 47 (42%) did not have OSA. In the OSA group, 13 (20%) were mild and 53 (80%) were moderate-severe. Nasal congestion (P=0.001), adenoid hypertrophy (P=<0.001), and tonsillar hypertrophy (P=0.04) reported at the time of referral were more common in the OSA group compared to the no-OSA group. Binary logistic regression analysis showed that referral from an otolaryngologist (odds ratio=2.6, 95% confidence interval=1.1 to 6.0) were associated with moderate-severe OSA. Conclusion A high rate of OSA was found among children aged 3 years and younger. Children referred by an otolaryngologist are more likely to be diagnosed with moderate-severe OSA. Children aged 3 years and younger with symptoms of OSA should be considered high-risk for OSA and be prioritized for early PSG and management.

Preoperative continuous positive airway pressure use improves the hospital experience of children undergoing adenotonsillectomy for obstructive sleep apnea

“…Children prescribed CPAP were younger than those not prescribed therapy, consistent with the finding that younger children have more severe disease, however, the non-compliant children were also the youngest. 16,17 Compliance with preoperative CPAP therapy was associated with an overall reduction in hospital length of stay by 1 day, compared to those who were non-compliant. Though cost was not specifically assessed in the study, we suggest that compliance with CPAP therapy would positively impact on resource allocation and cost effectiveness for the hospital system.…”

The Ogival Palate: A New Risk Marker of Sudden Unexpected Death in Infancy?

“…In the current literature, the studies mostly concern school-age children or adults, and the clinical presentation of OSA in very young children is poorly described ( 41 , 42 ). None of the parents of the deceased children in our study spontaneously described strong signs of breathing disorders during sleep, such as snoring, agitated sleep, or mouth breathing.…”