Sleep‐disordered breathing in a predominantly African‐American pediatric population

Abstract

SUMMARYThe goal of this study was to characterize sleep and respiratory parameters in children with sleep-disordered breathing (SDB) as compared to children without SDB. Data are from 198 children and adolescents referred for sleep center evaluation, 128 of whom were diagnosed with SDB. In children with SDB, obesity (> 95% wgt for age) was more common than being severely underweight (< 5% wgt for age), but only the older children with SDB were heavier than age-matched normal sleepers. Children with SDB had increased EEG arousals; sleep architecture was not otherwise significantly different from the non-SDB group. African-American children with SDB had significantly greater oxygen desaturation with obstructive events compared to Caucasian and Latino children. It appears that the role of obesity as a risk factor for obstructive sleep apnea (OSA) increases in children above the age of 8-years. Additionally, African-American children with SDB may be at increased risk for hypoxemia and cardiovascular consequences of SDB.

Obstructive sleep apnea and history of asthma in snoring children

“…Consistent with the literature [5,6,21,32] we found that African-American children were 3.13 times more likely to have OSA and 4.9 times more likely to have asthma than other children. There was also an increased risk of OSA in children on medical assistance compared to those with private insurance.…”

“…Sleep disturbances as a consequence of nocturnal asthma have been reported in children [3], but there is only a small body of literature describing polysomnographic (PSG) features in asthma. Respiratory illnesses such as asthma, which affects 7.5-10% of American children, and atopy are reported to be risk factors for the development of OSA [4][5][6].…”

Inter‐ and intra‐rater reliability of neck circumference measurements in children

“…29 However, the etiology and incidence of childhood OSA are evolving to resemble adult disease with the increasing prevalence of childhood obesity. 1,[30][31][32][33] In adults, OSA is linked to obesity. [34][35][36][37][38] In a prospective evaluation of adults, NC corrected for height was actually a better predictor of OSA than symptoms or general obesity, as assessed by body mass index (BMI).…”

Obstructive sleep apnea and tonsillectomy: do we have a new indication for extended postoperative observation?

“…[20][21][22][23] Additional covariates such as body positions during sleep, obesity, gender, and ethnic origin may also be important; these covariates were not all quantitated in the Koomson study. [24][25][26][27] Regardless of the flaws in the Koomson study, they have turned over a rock and now new interesting questions have been raised. We challenge them or other investigators to perform a prospective study that controls for anesthetic technique, surgeon, opioid use, body habitus, ethnic origin, and surgical technique and collects all oximeter and apnea data continuously while also tracking the child's sleep position.…”

“…[20][21][22][23] Des covariables supplémentaires, comme la position du corps pendant le sommeil, l'obésité, le sexe et l'origine ethnique pourraient aussi être importantes, mais elles ne sont pas quantifiées dans l'étude de Koomson. [24][25][26][27] Mis à part les défauts de l'étude, les auteurs ont mis au jour de nouveaux faits et soulevé de nouvelles questions fort intéressantes. Le défi leur est lancé, ainsi qu'à d'autres chercheurs, de réaliser une étude prospective qui tienne compte de la technique anesthésique, du chirurgien, de l'usage d'opioïdes, de la morphologie corporelle, de l'origine ethnique et de la technique chirurgicale, et qui recueille toutes les données de l'oxymétrie et de l'apnée de façon continue tout en notant la position de l'enfant pendant le sommeil.…”