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Prevalence of obstructive sleep apnea syndrome in Japanese elementary school children aged 6–8 years



We aimed to determine the prevalence of and the risk factors for obstructive sleep apnea syndrome (OSAS) in Japanese children aged 6–8 years.


The parents of 202 children aged 6–8 years who attended a single elementary school in Shiga, Japan, were requested to complete the Child and Adolescent Sleep Checklist (CASC) and perform home Type 3 portable monitoring of their children. By using the CASC data and monitor recordings, we estimated the prevalence of pediatric OSAS with the help of different diagnostic criteria and identified the risk factors associated with OSAS.


Complete data were obtained from 170 of the 194 children whose parents participated in the study. The mean total apnea–hypopnea index and obstructive apnea hypopnea index were 1.4 ± 1.3 and 0.4 ± 0.6 h−1, respectively, and central apnea was the most prevalent type of respiratory event, accounting for 70.4 % of all events. The overall prevalence of OSAS ranged from 0.6 % to 43.5 %, depending on the cutoff value used, and was 3.5 % when using International Criteria of Sleep Disorders version II (ICSD II) diagnostic criteria. The presence of tonsillar hypertrophy was the only parameter whose prevalence was significantly elevated in children with OSAS across all diagnostic criteria.


The prevalence of pediatric OSAS varies according to the diagnostic criteria used, indicating the need for further research focusing on outcomes to define a clinically significant diagnostic threshold. The presence of tonsillar hypertrophy is an important risk factor in the development of pediatric OSAS.

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The authors thank the staff of the Department of Sleep Medicine, Shiga University of Medical Science, for logistical support and the school staff, children, and their parents for their cooperation and participation. This work was supported by a Grant-in-Aid for Scientific Research (B) (no. 21390461) from the Japanese Society for the Promotion of Science.

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We have no conflicts of interest or financial interests to declare.

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Correspondence to Takuro Kitamura.

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Kitamura, T., Miyazaki, S., Kadotani, H. et al. Prevalence of obstructive sleep apnea syndrome in Japanese elementary school children aged 6–8 years. Sleep Breath 18, 359–366 (2014).

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  • Apnea
  • Hypopnea
  • International Classification of Sleep Disorders version II
  • Rhinomanometry
  • Tonsillar hypertrophy
  • Type 3 portable monitoring