JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2018, Vol. 32 ›› Issue (2): 25-29.doi: 10.6040/j.issn.1673-3770.0.2018.086

Previous Articles     Next Articles

Risk factors associated with obstructive sleep apnea-hypopnea syndrome in children: a retrospective case-control study

SHEN Ling, LIN Zongtong, LIN Xing, YANG Zhongjie   

  1. Department of Otorhinolaryngology, Fuzhou Childrens Hospital of Fujian Province, Fuzhou 350005, Fujian, China
  • Received:2018-02-06 Online:2018-03-20 Published:2018-03-20

Abstract: Objective The aim of this study was to investigate the potential risk factors for pediatric obstructive sleep apnea-hypopnea syndrome(OSAHS)and their possible synergistic effects. Methods Three hundred and twenty-one children with OSAHS diagnosed by polysomnography and a control group comprising 321 children matched for age and sex but without obstruction of the upper respiratory tract were enrolled between January 2016 and January 2017. The data from cases and controls were analyzed retrospectively. Results Multivariate logistic regression analysis showed that adenoid hypertrophy, tonsil hypertrophy, and chronic sinusitis were independent risk factors for pediatric OSAHS(P<0.05). The incidence of pediatric OSAHS was 3.229 78 times higher when chronic sinusitis was present than when it was not(P<0.001). When compared with grade Ⅰ tonsils, the ORs for grade Ⅱ, grade Ⅲ, and grade Ⅳ tonsils were 1.596 58(P=0.032 2), 2.306 52(P=0.000 8), and 4.430 85(P<0.001), respectively. When compared with grade Ⅰ adenoids, the ORs for grade Ⅱ, grade Ⅲ, and grade Ⅳ adenoids were 1.804 33(P=0.005 1), 2.883 38(P<0.001), and 3.220 91(P=0.000 2), respectively. Stratification analysis showed that the degree of adenoid hypertrophy was greater in patients with chronic sinusitis and was associated with a gradual increase in risk of OSAHS(P=0.004 1). Conclusion The causes of obstructive sleep apnea syndrome in children are multifactorial. Adenoid hypertrophy, tonsil hypertrophy, and chronic sinusitis may be potential risk factors for pediatric OSAHS. Chronic sinusitis could act synergistically with hypertrophic adenoids to increase the risk of OSAHS.

Key words: Risk factors, Sleep apnea, obstructive, Case-control study, Interaction

CLC Number: 

  • R765.41
[1] Goldstein NA. Evaluation and management of pediatric obstructive sleep apnea[M]. PART VIII,Saunders, 2014: 2854-2864.
[2] Marcus CL, Brooks LJ, Draper KA, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome[J]. Pediatrics, 2012, 130(3):e714-755.
[3] Marcus CL, Moore RH, Rosen CL, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea[J]. N Engl J Med, 2013, 368(25):2366-2376.
[4] Bhattacharjee R, Kheirandish-Gozal L, Spruyt K, et al. Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study[J]. Am J Respir Crit Care Med, 2010, 182(5):676-683.
[5] Wei JL, Mayo MS, Smith HJ, et al. Improved behavior and sleep after adenotonsillectomy in children with sleep-dis ordered breathing[J]. Arch Otolaryngol Head Neck Surg, 2007, 133(10):974-979.
[6] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉科学分会. 儿童阻塞性睡眠呼吸暂停低通气综合征诊疗指南草案(乌鲁木齐)[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(2):83-84. Editorial Board of Chinese Journal of Otorhinolary. Chinese Otorhinolaryngology of Chinese Medical Ass. Draft of guidelines for the diagnosis and treatment of pediatric sleep apnea hypopnea syndrome(Urumqi)[J].Chin J Otorhinolaryngol Head Neck Surg, 2007, 42(2):83-84.
[7] 黄健聪, 叶进, 杨钦泰, 等. 阻塞性睡眠呼吸暂停低通气综合征患儿临床指标与睡眠监测的相关性分析[J]. 临床耳鼻咽喉头颈外科杂志, 2009, 23(18): 837-839. HUANG Jiancong, YE Jin, YANG Qintai, et al. Correlation between clinic and polysomnographic findings in children with obstructive sleep apnea hypopnea syndrome[J]. Clin J Otorhinolarynol Head Neck Surg, 2009, 23(23): 837-839.
[8] Tang A, Benke JR, Cohen AP, et al. Influence of tonsillar size on OSA improvement in children undergoing adenotonsillectomy[J]. Otolaryngol Head Neck Surg, 2015, 153(2):281-285.
[9] Guilleminault C, Huang YS, Glamann C, et al. Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey[J]. Otolaryngol Head Neck Surg, 2007, 136(2):169-175.
[10] Mitchell RB, Kelly J. Outcome of adenotonsillectomy for obstructive sleep apnea in obese and normal-weight children[J]. Otolaryngol Head Neck Surg, 2007, 137(1):43-48.
[11] 沈翎, 许杨杨, 林宗通, 等. 儿童阻塞性睡眠呼吸暂停低通气综合征与鼻部疾病关系的初步研究[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(6):507-510. SHEN Ling, XU Yangyang, LIN Zongtong, et al. Relationship between childrens obstructive sleep apnea hypopnea syndrome and nasal diseases[J]. Chin J Otorhinolarynol Head Neck Surg, 2013, 48(6):507-510.
[12] Neff L, Adil E A. What is the role of the adenoid in pediatric chronic rhinosinusitis?[J]. Laryngoscope, 2014, 125(6):1282-1283.
[13] Shin KS, Cho SH, Kim KR, et al. The role of adenoids in pediatric rhinosinusitis[J]. Int J Pediatr Otorhinolaryngol, 2008, 72(11):1643.
[14] Waters KA, Cheng ATL. Adenotonsillectomy in the context of obstructive sleep apnoea[J]. Paediatr Respi Rev, 2009, 10(1):25-31.
[15] 沈翎, 林宗通, 许杨杨, 等. 儿童OSAHS与腺样体和扁桃体大小的关系探讨[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(6):381-385. SHEN Ling, LIN Zongtong, Xu Yangyang, et al. The relationship between obstructive sleep apnea hypopnea syndrome and adenoid size as well as tonsil size in children[J]. Clin J Otorhinolarynol Head Neck Surg, 2014, 28(6):381-385.
[16] 孔维佳, 周梁.耳鼻咽喉头颈外科学[M]. 3版. 北京:人民卫生出版社, 2015: 288-289.
[17] 中华耳鼻咽喉头颈外科杂志编辑委员会. 儿童鼻-鼻窦炎诊断和治疗建议(2012年,昆明)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(3):177-179.
[18] Leach J, Olson J, Hermann J, et al. Polysomnographic and clinical findings in children with obstructive sleep apnea[J]. Arch Otolaryngol Head Neck Surg, 1992, 118(7):741-744.
[19] Brooks LJ, Stephens BM, Bacevice AM. Adenoid size is related to severity but not the number of episodes of obstructive apnea in children[J]. J Pediatrics, 1998, 132(4):682-686.
[20] 林镝. 不同梗阻平面对儿童阻塞性睡眠呼吸暂停低通气综合征的影响[J]. 江苏医药, 2009, 35(11):1273-1274. LIN Di. Effect of different obstruction plane on obstructive sleep apnea-hypopnea syndrome in children[J]. Jiangsu Med J, 2009, 35(11):1273-1274.
[21] Toros SZ, Noseri H, Ertugay CK, et al. Adenotonsillar hypertrophy: does it correlate with obstructive symptoms in children?[J]. Int J Pediatric Otorhinolaryngol, 2010, 74(11):1316-1319.
[22] Tagaya M, Nakata S, Yasuma F, et al. Relationship between adenoid size and severity of obstructive sleep apnea in preschool children[J]. Int J Pediatr Otorhinolaryngol, 2012, 76(12):1827-1830.
[23] Sin S, Wootton DM, Mcdonough JM, et al. Anterior nasal resistance in obese children with obstructive sleep apnea syndrome[J]. Laryngoscope, 2014, 124(11):2640-2644.
[1] LI Zewen, GUO Junyu, ZHOU Jie, YAN Fubo, YANG Zhimin, DING Zhuhua. Relationship between gastroesophageal reflux disease and laryngeal carcinoma: a meta-analysis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 40-46.
[2] ZHAO Yuan-qing1, GUO Jia-liang1, ZHANG Feng2. Research progress of obstructive sleep apnea hypopnea syndrome and cardiovascular diseases [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(2): 33-37.
[3] MEI Fang, CHEN Zhi-jun. Retinopathy of prematurity in extremely low birth weight infants and very low birth weight infants and its risk factors [J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(4): 76-78.
[4] LI Ye, LU Meiping, TANG Shaowen, SHEN Chong. Risk factors of snoring among college students [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2009, 23(1): 1-3 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!