Pediatric sleep-disordered breathing during the COVID-19 pandemic

Introduction: Children with sleep-disordered breathing (SDB) are evaluated using polysomnography (PSG) and parent- reported measures prior to tonsillectomy and adenoidectomy (T&A). Elective T&As continue to be delayed during the COVID-19 pandemic. Therefore, we hypothesized that the average severity of SDB was greater in children presenting during the pandemic. Method: We performed a prospective study of children aged 5 to 17 years who presented to our tertiary care academic pediatric otolaryngology practice for evaluation of SDB between June 15, 2020, and December 12, 2020. We assessed parentreported disease severity using the Pediatric Sleep Questionnaire Sleep-Related Breathing Disorder (PSQ-SRBD) scale and objective severity using PSG. We compared SDB severity in these children with an age- and sex-matched prepandemic cohort. We compared average total PSQ score, apnea-hypopnea index (AHI), and oxygen saturation (SpO2) nadir in these 2 groups using t tests. A P value <.05 was considered significant. Results: A total of 23 patients have been enrolled in this study through December 3, 2020. The mean ± standard deviation (SD) PSQ total score was 11.4 ± 4.7 during the pandemic compared with 10.5 ± 4.0 in the prepandemic control group (P = .24). The mean ± SD AHI was 13.5 ± 14.3 in the pandemic cohort compared with 15.6 ± 18.1 in the prepandemic control group (P = .45). Similarly, the mean ± SD SpO2 nadir was 0.9 ± 0.1 in the pandemic cohort compared with 0.9 ± 0.1 in the control group (P = .25). Conclusion: There was no difference in SDB severity between children referred during the pandemic compared with those referred prior to it. These results suggest that caregivers and pediatricians view SDB as a problem that merits further evaluation and management even in the context of the pandemic. A strength of this study is the age- and sex-matching of controls. Weaknesses include the small sample size and the selection bias related to a single center. Future studies will focus on expanding the enrollment and the effect of T&A on the pandemic cohort.