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Prevalence of sleep-disordered breathing and associated risk factors in primary school children in urban and rural environments

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Introduction

Sleep-disordered breathing (SDB) in primary school children is a significant problem, yet its prevalence is not well known outside large urban settings. Information on the burden and risk factors of SDB in children could be used to improve resource allocation when providing care across a large country. The objectives of this study were to assess the prevalence of SDB among school-aged children comparing rural and urban settings, and to investigate associated risk factors.

Methods

In this cross-sectional study, a random sample of primary school students in Turkey were selected from urban and rural areas and data were collected using the Pediatric Sleep Questionnaire, asthma, and allergic rhinitis questionnaires completed by the parents.

Results

Questionnaires were collected from a total of 139 schools from 58 provinces. A total of 11,013 students were contacted, and 9045 (73%) completed the study. There was no difference in the prevalence of SDB between rural and urban settings (16% vs. 15%, p = 0.612). Multivariate logistic regression analysis revealed that current wheezing, current rhinoconjunctivitis, being overweight, parental snoring, and current mold at home were significant risk factors for SDB in both rural and urban children. Current tobacco smoke exposure (OR = 1.48, 95%CI = 1.19–1.85), near roadway air pollution exposure (OR = 1.40, 95%CI = 1.108–1.791), and mold at home in the first year of life (OR = 1.68, 95%CI = 1.26–2.23) were associated with SDB in urban children. History of maternal/paternal adenotonsillectomy was a significant predictor of SDB in the rural setting (OR = 1.63, 95%CI = 1.12–2.39).

Conclusion

The prevalence of SDB is high in children living in both settings but associated risk factors may vary. Children residing in rural areas should also be screened for sleep-disordered breathing during routine health visits.

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Acknowledgments

This study was developed as an American Thoracic Society MECOR (Methods in Epidemiologic, Clinical, and Operations Research) TURKEY project.

Funding

This study was funded by research grants from the Turkish Thoracic Society and Turkish Ministry of Health. The study was granted by TUBITAK 1507 R&D projects. Grant number: 7121045.

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Authors and Affiliations

  1. Department of Pediatric Pulmonology, School of Medicine, Marmara University, Fevzi Cakmak mah. Mimar Sinan Cad. No:41 Ust Kaynarca Pendik, Istanbul, Turkey

    Yasemin Gokdemir, Nilay Bas Ikizoglu, Fazilet Karakoc, Bulent Karadag & Refika Ersu

  2. Department of Pediatric Allergy & Immunology, Ankara Children’s Hematology Oncology Training and Research Hospital, Ankara, Turkey

    Ersoy Civelek

  3. Department of Public Health, School of Medicine, Hacettepe University, Ankara, Turkey

    Banu Cakir

  4. Department of Pulmonology, School of Medicine, Hacettepe University, Ankara, Turkey

    Ahmet Demir

  5. Department of Pediatric Allergy & Immunology, School of Medicine, Mugla Sitki Kocman University, Mentese, Mugla, Turkey

    Can Naci Kocabas

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  1. Yasemin Gokdemir
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Correspondence to Yasemin Gokdemir.

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Gokdemir, Y., Civelek, E., Cakir, B. et al. Prevalence of sleep-disordered breathing and associated risk factors in primary school children in urban and rural environments. Sleep Breath 25, 915–922 (2021). https://doi.org/10.1007/s11325-020-02206-x

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