Sleep Disordered Breathing in Children in a General Population Sample: Prevalence and Risk Factors

THE PREVALENCE OF SLEEP DISORDERED BREATHING (SDB) IN CHILDREN, BASED ON OBJECTIVE FINDINGS, HAS BEEN ESTIMATED IN SEVERAL STUDIES.1–10 These prevalence estimates have varied widely from 0.7% to 13.0%. This wide range of prevalence is at least partially due to the fact that SDB in children was defined based on an assortment of methods of assessing for the presence of SDB. These methods included: only hemoglobin oxygen saturation (SpO2)2,8; SpO2 + airflow3,4; and SpO2 + airflow + effort.5,7,9 Only 3 of these studies used a full polysomnogram (PSG),1,6,10 however, the number of subjects evaluated in these PSG studies was very small (N = 12–50). The majority of these studies had relatively narrow age ranges,2–4,6–10 while others had relatively wide age ranges.1,5 Some of these studies were primarily focused on ages < 6 years 2–4,8 while others included subjects as old as 18 years.1,5 Another limitation of the available studies is that they have not systematically assessed a wide range of risk factors that may contribute to SDB in children. This may reflect the paucity studies large enough to evaluate potential variables. Thus, the objectives of this study were (1) to establish the prevalence of SDB based on cutoff points of respiratory events that we have previously observed to be associated with a clinically significant risk (i.e., elevated systolic blood pressure), and (2) to identify independent risk factors for SDB. This study is based on the largest population-based sample of elementary school-aged children available to date.