Clinical differences between preschoolers and school children with obstructive sleep apnea

Abstract

OBJECTIVE: To describe the clinical features, assess the impact of age and identify the factors associated with the severity of obstructive sleep apnea in a group of preschool and school children’s. MATERIALS AND METHODS: Observational and retrospective study, conducted in children of 3 to 12 years-old, with obstructive sleep apnea, treated at the National Institute of Respiratory Diseases Ismael Cosío Villegas, between January 1 and December 31, 2014. The clinical was described with the information contained in the records. The parents of the children sent to the Sleep Medicine Unit answered a standardized questionnaire of sleep symptoms and comorbidities. For the analysis of the information descriptive statistics were used. The normality of the data distribution was checked with the Kolmogorov Smirnov test. Dichotomous variables were evaluated with c2 and continuous variables with Student's t. RESULTS: 108 preschoolers and 136 schoolchildren were registered. The 74% had tonsil hypertrophy. The most frequent symptoms were: habitual snoring, nocturnal oral breathing and chronic cough (73, 72 and 70%, respectively). Preschoolers had a higher frequency of gastroesophageal reflux disease (38% vs. 22%) and schoolchildren were more obese (13% vs 39%) and with more heart disease (4% vs 10%, p <0.05). The frequency of obstructive severe sleep apnea was higher in preschoolers (76 vs. 62%, p = 0.01). In preschoolers, snoring, witnessed apneas, night drowning, parental night surveillance and tonsil hypertrophy was associated with the severity of the disease (OR 3.58, 5.92, 5.37, 5.89, 2.17, respectively, p <0.05). CONCLUSIONS: The age group is associated with differences in the clinical manifestation of obstructive sleep apnea, severity of illness and use of positive pressure equipment.