Author(s)
Danielle Collado1
Romaine Johnson1,2
Ron Mitchell1,2
Affiliation(s)
1 University Of Texas Southwestern Medical Center, 2 Children's Medical Center
Abstract:
INTRODUCTION: Pediatric obstructive sleep apnea (OSA) most commonly affects children 3 years or older. Few studies describe OSA in children under 3. OBJECTIVES: To describe the demographic, clinical, and polysomnographic characteristics of children under 3 and predictors of severe OSA in this cohort. METHODS: This study included children under 3 who underwent polysomnography between 08/01/2012-06/01/2017 at a tertiary care Medical Center. Demographic, clinical, and polysomnography data were obtained from the electronic medical records. The following comparisons were made: obese versus non-obese; age 0-1 and 1-3; children with or without significant comorbidities. Pearson chi-squared, ANOVA, and logistic regression were used for analysis. A P<0.05 was considered significant. RESULTS: 332 patients were included in this study. Approximately, 17% were between 0-1 years and 216 were male (65%). The cohort was 26% Caucasian, 26% African American, 42% Hispanic, and 6.6% "Other". Co-morbidities included 18% preterm infants, 19% allergic rhinitis, 27% gastroesophageal reflux, 17% asthma, 4.2% down syndrome, 7.5% cardiac issues, 9.3% craniofacial issues, and 1.8% sickle cell disease. A total of 49% patients had tonsillar hypertrophy. Comparison of 0-1 and 1-3 years, obese versus non-obese, and with or without comorbidities, showed no significant differences in clinical or polysomnography data. Tonsillar hypertrophy predicted severe OSA (OR=1.97: p=0.005). CONCLUSION: Children under 3 with OSA are more likely to be male and have comorbidities. Tonsillar hypertrophy is the primary predictor for severe OSA in young children. Additional research is needed to determine the outcomes of surgical therapy for OSA in children under 3.