Clinical predictors of sleep disordered breathing in children at moderate altitude

Background

Validated clinical indicators of sleep disordered breathing (SDB) in children are scarce and none generated at moderate altitude where hypoxemic complications could be frequent and oximetry evaluation might be very efficient.

Methods

A total of 158 children consecutively referred to a sleep clinic in Mexico City (2240 m) for suspected sleep apnea underwent clinical evaluation and nocturnal monitoring of pulse oximetry, snoring and body position.

Results

Mean age was 4.9 years (SD 2.5) and 68.4% were males. A total of 84% of children were found with more than five desaturations per hour (≥4%) while 63% and 34% had more than 10 and 20 desaturations, respectively. Based on logistic regression models, age ≤5 was the only predictor for more than five desaturations per hour (OR 4.5, 95% CI 1.6–12.6). Clinical predictors of more than 10 desaturations were age ≤5 years (OR 4.0, 95% CI 1.9–8.8), obesity (OR 3.5, 95% CI 1.3–9.1), enlarged tonsils (OR 3.5, 95% CI 1.6–8.1) and male gender (OR 2.4, 95% CI 1.1–5.2). Witnessed apneas (OR 3.1, 95% CI 1.7–7.0), age ≤5 years (OR 2.6; 95% CI 1.2–5.5), obesity (OR 2.4, 95% CI 1.0–5.6) and simultaneous enlargement of adenoids and tonsils predicted more than 20 desaturations (OR 2.4; 95% CI 1.0–5.8).

Conclusions

Age, gender, witnessed apneas, enlarged tonsils or adenoids and obesity were clinical predictors of SDB in children referred to a sleep clinic at moderate altitude.

Key words: Tonsillitis, Snoring, Sleep apnea, Sleep disordered breathing, Oxygenation, Children