Skip to main content
SpringerLink
Log in

Prevalence of sleep-disordered breathing in Japanese children: efficiency of screening with nocturnal pulse oximetry

  • Original Article
  • Published:
Sleep and Biological Rhythms Aims and scope Submit manuscript

Abstract

The purposes of this study were: (1) to confirm the prevalence of sleep-disordered breathing (SDB) in Japanese children using nocturnal pulse oximetry (NPOx) as a screening tool and (2) to examine what kind of parameters are suitable for the evaluation of SDB in children. We conducted a study of 99 children between 4 and 15-year-old and obtained their demographic characteristics and the presence of SDB-related symptoms by questionnaire from their parents. In our study, 36% had been Down syndrome (DS), 25% had cardiovascular disease and 34% had dental/oral abnormality. As SDB-related symptoms, snoring (35%), awake disturbance (48%), arousal (41%) and nocturia (19%) were reported. We analyzed each parameter based on the previous reported data of children and temporary defined normal range as follows; 3%ODI < 2.04, 4%ODI < 0.78, SpO2 nadir > 89% and McGill oximetry score = 1. In non-DS group, each parameter showed abnormal value especially in younger group (abnormality; 61–94%), but the abnormality was decreased during the growth (abnormality; 11–63%). Interestingly, in DS group the value of each parameter was kept on abnormal during the growth (abnormality; 55–100%). We investigated the correlation between McGill oximetry score and ODI or SpO2 nadir. There was a significant positive correlation between McGill oximetry score and 3% or 4% ODI. Moreover, there was a significant negative correlation between McGill oximetry score and SpO2 nadir. Based on NPOx screening, prevalence of SDB was high; however, it was decreased during the growth in non-DS group. Each parameter might be useful for SDB screening in children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.

    Article  CAS  Google Scholar 

  2. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006–14.

    Article  Google Scholar 

  3. McNicholas WT, Bonsigore MR, Management Committee of EU COST ACTION B26. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J. 2007;29:156–78.

    Article  CAS  Google Scholar 

  4. Strohl KP, Brown DB, Collop N, George C, Grunstein R, Han F, Kline L, Malhotra A, Pack A, Phillips B, Rodenstein D, Schwab R, Weaver T, Wilson K, ATS Ad Hoc Committee on Sleep Apnea, Sleepiness, and Driving Risk in Noncommerical Drivers. An official American Thoracic Society clinical practice guideline: sleep apnea, sleepiness, and driving risk in noncommercial drivers. An update of a 1994 statement. Am J Respir Crit Care Med. 1994;2013(187):1259–66.

    Google Scholar 

  5. Guilleminault C, Lee JH, Chan A. Pediatric obstructive sleep apnea syndrome. Arch Pediatr Adolesc Med. 2005;159:775–85.

    Article  Google Scholar 

  6. Mitchell RB, Kelly J. Behavior, neurocognition and quality-of-life in children with sleep-disordered breathing. Int J Pediatr Otorhinolaryngol. 2006;70:395–406.

    Article  Google Scholar 

  7. Papaioannou G, Kambas I, Tsaoussoglou M, Panaghiotopoulou-Gartagani P, Chrousos G, Kaditis AG. Age-dependent changes in the size of adenotonsiller tissue in childhood: implications for sleep-disordered breathing. J Pediatr. 2013;162:269–74.

    Article  Google Scholar 

  8. Li HY, Huang YS, Chen NH, Fang TJ, Lee LA. Impact of adenotonsillectomy on behavior in children with sleep-disordered breathing. Laryngoscope. 2006;116:1142–7.

    Article  Google Scholar 

  9. Kitamura T, Miyazaki S, Kadotani H, Suzuki H, Kanemura T, Kodama I, Nishikawa M, Kobayashi R, Okawa M. Prevalence of obstructive sleep apnea syndrome in Japanese elementary school children aged 6–8 years. Sleep Breath. 2014;18:359–66.

    Article  Google Scholar 

  10. Kobayashi R, Miyazaki S, Karaki M, Hoshikawa H, Nakata S, Hara H, Kikuchi A, Kitamura T, Mori N. Obstructive sleep apnea in Asian primary school children. Sleep Breath. 2014;18:483–9.

    Article  Google Scholar 

  11. Tahara S, Hara H, Yamashita H. Evaluation of body growth in prepubertal Japanese children with obstructive sleep apnea after adenotonsillectomy over a long postoperative period. Int J Pediatr Otorhinolaryngol. 2015;79:1806–9.

    Article  Google Scholar 

  12. Ono J, Chishaki A, Ohkusa T, Sawatari H, Nishizaka M, Ando S. Obstructive sleep apnea-related symptoms in Japanese people with Down syndrome. Nurs Health Sci. 2015;17:420–5.

    Article  Google Scholar 

  13. Kuroda H, Sawatari H, Ando S, Ohkusa T, Rahmawati A, Ono J, Nishizaka M, Hashiguchi N, Matsuoka F, Chishaki A. A nationwide, cross-sectional survey on unusual sleep postures and sleep-disordered breathing-related symptoms in people with Down syndrome. J Intellect Disabil Res. 2017;61:656–67.

    Article  CAS  Google Scholar 

  14. Nixon GM, Kermack AS, Davis GM, Manoukian JJ, Brown KA, Brouillette T. Planning adenotonsillectomy in children with obstructive sleep apnea: the role of overnight oximetry. Pediatrics. 2004;113:e19–25.

    Article  Google Scholar 

  15. Brouillette RT, Morielli A, Lemianis A, Waters KA, Luciano R, Ducharme FM. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep aonea. Pediatrics. 2000;105:405–12.

    Article  CAS  Google Scholar 

  16. Saito H, Araki K, Ozawa H, Mizutari K, Inagaki K, Habu N, Yamashita T, Fujii R, Miyazaki S, Ogawa K. Pulse-oximetery is useful in determining the indications for adeno-tonsillectomy in pediatric sleep-disordered breathing. Int J Pediatr Otorhinolaryngol. 2007;71:1–6.

    Article  Google Scholar 

  17. Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc. 2008;5:242–52.

    Article  Google Scholar 

  18. Bixler EO, Vgontzas AN, Lin HM, Liao D, Calhoun S, Vela-Bueno A, Fedok F, Vlasic V, Graff G. Sleep disordered breathing in children in a general population sample: prevalence and risk factors. Sleep. 2009;32:731–6.

    Article  Google Scholar 

  19. Li AM, So HK, Au CT, Ho C, Lau J, Ng SK, Abdullah VJ, Fok TF, Wing YK. Epidemiology of obstructive sleep apnoea syndrome in Chinese children: a two-phase community study. Thorax. 2010;65:991–7.

    Article  Google Scholar 

  20. American Academy of Sleep Medicine. International classification of sleep disorders. Diagnostic and coding manual. 2nd ed. Westchester: American Academy of Sleep Medicine; 2005.

    Google Scholar 

  21. Kaditis A, Kheirandis-Gozal L, Gozal D. Pediatric OSAS: oximetry can provide answers when polysomnography is not available. Sleep Med Rev. 2016;27:96–105.

    Article  Google Scholar 

  22. Goodwin JL, Vasquez MM, Silva GE, Quan SF. Incidence and remission of sleep-disordered breathing and related symptoms in 6- to 17-year old children—The Tucson Children’s Assessment of Sleep Apnea Study. J Pediatr. 2010;157:57–61.

    Article  Google Scholar 

  23. Scholle S, Wiater A, Scholle HC. Normative values of polysomnographic parameters in childhood and adolescence: cardiorespiratory parameters. Sleep Med. 2011;12:988–96.

    Article  Google Scholar 

  24. Bonuck KA, Freeman K, Henderson J. Growth and growth biomaler changes after adenotonsillectomy: systematic review and meta-analysis. Arch Dis Child. 2009;94:83–91.

    Article  CAS  Google Scholar 

  25. Kohler MJ, Lushington K, van den Heuvel CJ, Martin J, Pamula Y, Kennedy D. Adenotonsillectomy and neurocognitive deficits in children with sleep disordered breathing. PLoS One. 2009;4:e7343.

    Article  Google Scholar 

  26. Maris M, Verhulst S, Wojciechowski M, Van de Heyning P, Boudewyns A. Prevalence of obstructive sleep apnea in children with Down syndrome. Sleep. 2016;39:699–704.

    Article  Google Scholar 

  27. Bull MJ, the Committee on Genetics. Clinical report—Health supervision for children with Down syndrome. Pediatrics. 2011;128:393–406.

    Article  Google Scholar 

  28. Nakano H, Furukawa T, Hayashi M, Ohshima E, Nishikata N, Nagai Y, Sato M. A new oximetry algorithm for screening of sleep-disordered breathing. Ther Res. 2005;26:931–7 (in Japanese with English Abstract).

    Google Scholar 

Download references

Acknowledgements

The authors thank Ms. Yukiko Yamamoto, Oshima nursing school for technical support and the school staff, children, and their parents for their cooperation and participation. This research was supported by a Grant from Fukuda Foundation for Medical Technology.

Funding

This study was funded by Fukuda Foundation for Medical Technology.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Ube Frontier University, Bunkyodai, Ube, Yamaguchi, 755-0805, Japan

    Tomoko Nao & Tomoko Ohkusa

  2. Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Anita Rahmawati, Nobuko Moriyama & Akiko Chishaki

  3. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Mari Nishizaka

  4. Department of Cardiovascular Medicine, Kimura Hospital, Chiyo, Hakata-ku, Fukuoka, 812-0044, Japan

    Mari Nishizaka

  5. Department of Health Care for Adults, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, 734-0037, Japan

    Hiroyuki Sawatari

  6. Sleep Apnea Center, Kyushu University Hospital, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Shin-Ichi Ando

Authors
  1. Tomoko Nao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anita Rahmawati
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mari Nishizaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Sawatari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nobuko Moriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Akiko Chishaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shin-Ichi Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tomoko Ohkusa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomoko Nao.

Ethics declarations

Conflict of interest

Tomoko Nao declares that I have no conflict of interest. Anita Rahmawati declares that she has no conflict of interest. Mari Nishizaka declares that she has no conflict of interest. Hiroyuki Sawatari declares that he has no conflict of interest. Nobuko Moriyama declares that she has no conflict of interest. Akiko Chishaki declares that she has no conflict of interest. Shin-Ichi Ando declares that he has no conflict of interest. Tomoko Ohkusa declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical committee permission

All procedures were in accordance with the Ethical Committee of Ube Frontier University (approved no. 15004).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nao, T., Rahmawati, A., Nishizaka, M. et al. Prevalence of sleep-disordered breathing in Japanese children: efficiency of screening with nocturnal pulse oximetry. Sleep Biol. Rhythms 18, 37–47 (2020). https://doi.org/10.1007/s41105-019-00242-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41105-019-00242-z

Keywords

Search

Navigation