PREVALENCE AND CHARACTERISTICS OF SLEEP DISORDERED BREATHING IN 12-24 MONTH OLD CHILDREN: A SINGLE CENTER STUDY

Abstract Introduction To evaluate the prevalence and characteristics of obstructive sleep apnea (OSA) in children with ages between 12 to 24 months. Methods This was a single center, retrospective study that included children with ages 12-24 months who were evaluated for suspected sleep disordered breathing and underwent a full overnight polysomnography in an academic sleep disorders center over a period of 7 years. An apnea hypopnea index (AHI) >1 was used to define OSA, >5 was used to define moderate OSA, and >10 was used to define severe OSA. Results A total of 232 children with ages between 12-24 months were included in this study. The majority (66.4%) were noted to be males, and 56.9% were Caucasian. Snoring (90.1%) and witnessed apnea (53.3%) were the most common presenting symptoms for sleep evaluation. History of prematurity (18.2%) and gastroesophageal reflux (20.2%) were common co-morbidities. OSA was diagnosed in about 79% of the children and it was categorized as mild in 53.5%, moderate in 16.4 % and severe in 30.1%, respectively. There were no statistically significant differences in total sleep time, sleep efficiency, or the stages among these groups. However, statistical significant differences among the groups were noted in median REM% (Q1-Q3) (normal 19.3 (15-22.2) vs. mild 22.2 (18-26.6) vs. moderate 23.1(16-28) vs. severe 21(15-24.6) p=0.013), median REM AHI (normal 1.6 (1-2.8) vs. mild 7.5 (5-10.8) vs. moderate19.4 (12-23.6) vs. severe 51.2 (37-73.4) p<0.001), median OAHI (normal 0.3 (0-0.5) vs. mild 1.1 (1-2.6) vs. moderate 5.5 (4-7.5) vs. severe 20.7 (13-31.9) p<0.001), median supine AHI (normal-0.3 (0.0.6) vs. mild 1.7 (1-3.4) vs. moderate 6.3 (3-8.1) vs. severe 24.3(12-40.4) p<0.001), median SaO2 nadir (normal 94 (90-96) vs. mild 89 (84-91) vs. moderate 86.5 (82-91) vs. severe 80 (73-84) p<0.001), median arousal index (normal 8.9 (7-11.8) vs. mild 11.3 (9-13.5) vs. moderate 13.2 (11-18.6) vs. severe 16.8 (14-23.6) p<0.0001). Surgical treatment was performed in 98 children (53.5% of the children diagnosed with OSA) of which 76 surgeries were adenotonsillectomy. Conclusion In children with ages 12-24 months with suspected sleep disordered breathing, OSA was diagnosed in 79% with moderate to severe OSA in 46.5%. Support (If Any)