Risk of obstructive sleep apnea syndrome in Japanese men with a history of adenotonsillar hypertrophy

Objectives: Obstructive sleep apnea syndrome (OSAS) is an important cause of medical morbidity and mortality. Although adenotonsillar hypertrophy is linked to the pathogenesis of OSAS in children, the potential role of childhood adenotonsillar hypertrophy in the etiology of adult OSAS has not yet been examined. Methods: We retrospectively evaluated 1,369 men aged ≥20 years with suspected OSAS who had undergone polysomnography at Fujita Health University Hospital in Japan. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated after adjusting for age and body mass index to evaluate the risk of development of OSAS in men with a history of adenotonsillar hypertrophy in childhood. The reference category for OSAS was non-OSAS. Results: In total, 988 men were diagnosed with OSAS and 561 were diagnosed with severe OSAS (apnea–hypopnea index of ≥30). The adjusted ORs for a history of untreated adenotonsillar hypertrophy with OSAS and severe OSAS were 3.13 (95% CI, 1.18–8.27) and 4.31 (1.56–11.90), respectively. The adjusted ORs for a history of treated adenotonsillar hypertrophy with OSAS and severe OSAS were 1.31 (0.69–2.50) and 0.87 (0.41–1.90), respectively. Conclusions: This study confirmed the risk of untreated childhood adenotonsillar hypertrophy in the development of adult OSAS. Our data also support the idea that abnormal dentofacial morphology induced by adenotonsillar hypertrophy in childhood is a critical factor in the pathogenesis of OSAS in adulthood.