SNORING AND OBSTRUCTIVE SLEEP APNEA IN
THAI SCHOOL-AGE CHILDREN: PREVALENCE
AND PREDISPOSING FACTORS
Anuntaseree W1,
Rookkapan K2, Kuasirikul S3, Thongsuksai P4
Department of Pediatrics1,
Department of Otolaryngology2, Sleep Disorder Unit3,
and Clinical Epidemiology Unit4, Prince of Songkla University,
Hat yai, Songkla,
Thailand
Objective: To determine the prevalence of habitual snoring and
obstructive sleep apnea syndrome (OSAS) in
Thai school-age children and its predisposing factors.
Methods: Questionnaire survey was performed in a sample of
1,142 children aged 6-13 years (mean 7.25 + 0.58) from seven
randomly-selected schools in Hat yai, Southern Thailand. A case-control
study was used to determine the
predisposing factors. The selected cases of snoring children underwent
polysomnographic study to determine the lower limit of OSAS prevalence.
Results: Eighty-five (8.5%) of the children were habitual
snorers. Significant and independent association was present between
snoring and allergic rhinitis with an odds ratio (OR) of 5.27; 95% CI
1.57-17.77. The OR was significantly increased to 2.65, 5.72, and 11.06 in
children with tonsillar size of 2+, 3+ and 4+,
respectively. Of the 85
habitual snorers, 69 could be contacted. Eight of these were reported to
have at least one of sleep-related symptoms and underwent polysomnographic
studies. The studies demonstrated an apnea/hypopnea index of 0.6-4.7 per
hour. Seven children met the
criteria for OSAS. Thus our estimation of the lower limit of OSAS
prevalence in the Thai school-age children was 7/1008 (0.69%).
Conclusion: the prevalence of snoring and OSAS in a sample of
Asian school-age children in Southern Thailand was similar to that from
western populations. An association of snoring with tonsillar size or
allergic rhinitis was demonstrated. All but one of the snoring children
with sleep related-symptoms had OSAS, but all were mild cases.