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Prevalence of Obstructive Sleep Apnea Syndrome in a Cohort of 1,207 Children of Southern Italy^*

^* From the Department of Pediatrics, Clinica Pediatrica III (Drs. Brunetti, Rana, Lospalluti, Pietrafesa, and Armenio), the Department of Pediatrics, Clinica Pediatrica II (Dr. Francavilla), and Department of Medical Statistics (Dr. Fanelli), University of Bari, Bari, Italy.

Correspondence to: Luigia Brunetti, MD, Department of Pediatrics, Clinica Pediatrica III, Policlinico Piazza Giulio Cesare 70100, Bari, Italy

Study objective: To determine the prevalence of sleep-related breathing disturbances in a large cohort of school-aged and preschool-aged children of Southern Italy.

Design and setting: This cross-sectional prevalence study was designed in two phases: a screening phase aimed to identify symptomatic children from a cohort of 1,207 by a self-administered questionnaire, and an instrumental phase for the definition of sleep-related disorders.

Patients and methods: One thousand two hundred seven children were screened by a self-administered questionnaire. There were 612 female children (51%) and 595 male children (mean age, 7.3 years; range, 3 to 11 years). According to answers, children were classified in three groups: nonsnorers, occasional snorers, and habitual snorers. All habitual snoring children underwent a polysomnographic home evaluation, and those with an oxygen desaturation index > 2 were considered for nocturnal polygraphic monitoring (NPM). Children with an apnea/hypopnea index > 3 received a diagnosis of obstructive sleep apnea syndrome (OSAS).

Results: A total of 895 questionnaires (74.2%) were returned and scored; 710 children (79.3%) were identified as nonsnorers, 141 children (15.8%) were identified as occasional snorers, and 44 children (4.9%) were identified as habitual snorers. The percentage of male children who were habitual snorers was higher than the percentage of female children who were habitual snorers (6.1% vs 3.7%, respectively; p < 0.09). OSAS was diagnosed in nine children by NPM.

Conclusion: The lower limit of prevalence of OSAS in childhood is 1% (95% confidence interval [CI], 0.8 to 1.2). If we add the five children who underwent adenoidectomy and/or tonsillectomy because of worsening clinical condition and the two children who were shown to have evidence of OSAS on domiciliary oximetry, then the prevalence is 1.8% (higher limit of prevalence; 95% CI, 1.6 to 2.0).

Key Words: childhood • epidemiology • nocturnal polygraphic monitoring • obstructive sleep apnea syndrome • primary snoring

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