Obstructive sleep apnea syndrome(OSAS), a disorder characterized by partial or complete upper airway obstruction, leads to disruption of sleep. Prevalence varies from 2.2% in Caucasians to 8.7% in African-American children (Redline, 1997). OSAS are frequently associated with symptoms of ADHD in the general pediatric population, suggesting a mechanistic link between these conditions. However, there is no data on prevalence rates of sleep disordered breathing in Hispanic children, or its association with neurobehavioral disturbances.
A cross-sectional survey was performed in 1 to 11 year old Hispanic children recruited from the general pediatric clinic. The survey queried snoring and breathing patterns suggestive of sleep apnea, nocturnal arousals, excessive daytime sleepiness, and diagnosis or symptoms of attention deficit hyperactivity disorder (ADHD). Parents rated the frequency of their children’s symptoms in each of the first three categories using a likert scales: no symptoms in the last 6 months; 1/week; 3-4/week; >4/week. For data analysis, symptoms occurring 3 or more times per week were considered as persistent.
30(15 boys)patients were recruited. Age range: 1 to 9, average 5 years. 17% had persistent snoring, 6.7% had snoring and another persistent symptom, i.e. nocturnal arousals or excessive daytime sleepiness. None reported a diagnosis of ADHD or symptoms of hyperactivity.
This preliminary study provides initial estimates of the prevalence rate of snoring and symptoms of sleep disordered breathing in preadolescent Hispanic children. The risk for OSAS appears to be in the reported range of the general population. Furthermore, the prevalence seems to be higher than in Caucasians and lower than in African Americans (Redline, Am. J. Resp Crit. Care Med., 1997). Contrary to other ethnical groups, none of the patients had ADHD or hyperactivity symptoms by parental report, thereby suggesting a role for genetic and/or environmental/cultural factors in the mechanisms of OSAS and their neurobehavioral sequelae in children.
This data shows the importance of environmental/cultural factors, and the need to explore internalizing symptoms also, when associating sleep disordered breathing and external behavioral changes.
Y. Chung, None.