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Original Research: SLEEP MEDICINE |

Prevalence and Risk Factors of Habitual Snoring in Primary School Children

Albert M. Li, MD; Chun T. Au, MPhil; Hung K. So, PhD; Joseph Lau, PhD; Pak C. Ng, MD; Yun K. Wing, MBChB
Author and Funding Information

from the Department of Pediatrics (Drs Li, Au, So, and Ng), Centre for Epidemiology and Biostatistics (Dr Lau), and Department of Psychiatry (Dr Wing), Prince of Wales and Shatin Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

Correspondence to: Albert M. Li, MD, Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong; e-mail: albertmli@cuhk.edu.hk


For editorial comment see page 469

Funding/Support: This study was supported by the Research Grants Council of the Hong Kong Special Administrative Region, China [Grant CUHK4161/02M].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(3):519-527. doi:10.1378/chest.09-1926
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Objective:  Our study aimed to determine the prevalence of habitual snoring (HS) in primary school children and to evaluate the diurnal symptoms and conditions that may be associated with it.

Methods:  A validated questionnaire completed by parents was used to assess the sleep and daytime behaviors of Chinese children aged 5 to 14 years. Thirteen primary schools in two representative districts were randomly selected.

Results:  A total of 6,349 out of 9,172 questionnaires (response rate 69.2%) with complete answers were returned. The prevalence rate of HS was 7.2%. Male sex (odds ratio [OR] [95% CI]: 2.5 [1.7-3.6]), BMI z score (OR [95% CI]: 1.4 [1.1-1.6]), maternal HS (OR [95% CI]: 3.4 [2.0-5.7]), paternal HS (OR [95% CI]: 3.8 [2.7-5.5]), allergic rhinitis (OR [95% CI]: 2.9 [2.0-4.2]), asthma (OR [95% CI]: 2.4 [1.2-5.2]), nasosinusitis (OR [95% CI]: 4.0 [1.5-10.6]), and tonsillitis (OR [95% CI]: 3.1 [1.9-5.1]) in the past 12 months were identified to be independent risk factors associated with HS. HS was also associated with daytime, nocturnal, parasomniac, and sleep-related breathing symptoms. HS was demonstrated to be an independent risk factor for parent-reported poor temper (OR [95% CI]: 1.9 [1.4-2.5]), hyperactivity (OR [95%CI]: 1.7 [1.2-2.5]), and poor school performance (OR [95% CI]: 1.7 [1.2-2.5]).

Conclusions:  HS was a significant and prevalent problem in primary school children. Male sex, obesity, parental HS, atopic symptoms, and history of upper respiratory infections were significant risk factors. HS was also associated with sleep-disordered breathing symptoms and adverse neurobehavioral outcomes.

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snoring ; sleep

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