Associations among sleep symptoms, physical examination, and polysomnographic findings in children with obstructive sleep apnea
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The relationships among PSG findings, OSA symptoms, and tonsil and adenoid size are not clear. In this study, we aimed to investigate the associations between pediatric OSA and tonsil and adenoid size using subjective (OSA-18 questionnaire) and objective (PSG) measurements.
101 consecutive patients aged from 2 to 12 years (mean age, 5.4 ± 2.2 years; boys, 72.3%) diagnosed with OSA were enrolled in two age groups (2–6 years group and 7–12 years group) and underwent PSG and lateral cephalometric radiography. Tonsil size and the adenoid–nasopharyngeal (A/N) ratio were determined. Quality of life and sleep symptoms were measured using the Chinese version OSA-18 questionnaire. Demographic and clinical data were obtained.
75 and 26 patients were separately enrolled in 2–6 years group and 7–12 years group. In 2–6 years group, the multiple linear regression revealed that tonsil size and A/N ratio were associated with log apnea–hypopnea index (AHI), and the Spearman’s rank correlation reflected a positive correlation between log AHI and the OSA-18 sleep disturbance score (r = 0.362, P = 0.001). Log OSA-18 score was correlated with tonsil size (r = 0.349, P = 0.002) but not the A/N ratio in 2–6 years group. Finally, no significant associations were observed between log OSA-18 scores and log AHI in all patients.
As PSG stays the golden standard for diagnoses of pediatric OSA, physical examinations and quality-of-life assessments are needed to fully assess the impact of OSA on children.
KeywordsObstructive sleep apnea Physical examination Polysomnography OSA-18 questionnaire Pediatric sleep disorder
The authors thank Xiangdong Tang, professor of the Department of Sleep Medicine Center at West China Hospital at West China Hospital, for providing data regarding admissions to the Department of Otolaryngology Head and Neck Surgery in the study period.
This study was funded by the Key Research and Development Support Programmes of Chengdu Science and Technology Bureau [Grant no. 2018-YFYF-00123-SN] and the Fundamental Research Funds for the Central Universities [Grant no. 2012017yjsy118].
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of West China Hospital (2018 (146)) and was registered at chictr.org (ChiCTR1800017895).
Informed consent was obtained from all individual participants included in the study.
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