Study objective: To determine the prevalence of
sleep-related breathing disturbances in a large cohort of school-aged
and preschool-aged children of Southern Italy.
setting: This cross-sectional prevalence study was designed in
two phases: a screening phase aimed to identify symptomatic children
from a cohort of 1,207 by a self-administered questionnaire, and an
instrumental phase for the definition of sleep-related disorders.
Patients and methods: One thousand two hundred seven
children were screened by a self-administered questionnaire. There were
612 female children (51%) and 595 male children (mean age, 7.3 years;
range, 3 to 11 years). According to answers, children were classified
in three groups: nonsnorers, occasional snorers, and habitual snorers.
All habitual snoring children underwent a polysomnographic home
evaluation, and those with an oxygen desaturation index > 2 were
considered for nocturnal polygraphic monitoring (NPM). Children with an
apnea/hypopnea index > 3 received a diagnosis of obstructive sleep
apnea syndrome (OSAS).
Results: A total of 895
questionnaires (74.2%) were returned and scored; 710 children (79.3%)
were identified as nonsnorers, 141 children (15.8%) were identified as
occasional snorers, and 44 children (4.9%) were identified as habitual
snorers. The percentage of male children who were habitual snorers was
higher than the percentage of female children who were habitual snorers
(6.1% vs 3.7%, respectively; p < 0.09). OSAS was diagnosed in nine
children by NPM.
Conclusion: The lower limit of
prevalence of OSAS in childhood is 1% (95% confidence interval[
CI], 0.8 to 1.2). If we add the five children who underwent
adenoidectomy and/or tonsillectomy because of worsening clinical
condition and the two children who were shown to have evidence of OSAS
on domiciliary oximetry, then the prevalence is 1.8% (higher limit of
prevalence; 95% CI, 1.6 to 2.0).