How Common Is Obstructive Sleep Apnea In Children Or Is It A Rare Disease?

Obstructive sleep apnea is a relatively rare disease but its symptoms can individually be present commonly like snoring, insomnia, increased sleepiness during the daytime, etc.

The prevalence of the obstructive sleep apnea is calculated based upon the questionnaires prepared and answered by the parents of children affected which may or may not reliably produce the information, but rough estimates can be drawn from it. The various symptoms of obstructive sleep apnea have been separately asked and their problems have been established with it. According to the study performed, the prevalence of who were always snoring was between 1.5 to 6 % but only about 20 to 30% of those, were found to be suffering from obstructive sleep apnea. Another study gave a prevalence of about double ranging from 3% to 12%.^[1] The prevalence of apnea events was reported to be only about 0.2 to 0.4% by the parents and the diagnosis of obstructive sleep apnea was made only in 4 to 11% based upon the various criteria and questionnaires. The prevalence of the condition was found to rise with the increasing age and maximum in the elderly age group.

In recent years there has been a surge in the number of cases of obstructive sleep apnea in children. It can be attributed to various factors like that of increased obesity among children, luxurious lifestyle, decreased exercise and activities, etc. In the era of 1990, there were less than 15% cases of total obstructive sleep apnea who also reported with the obesity seen in children whereas after 2014 this number has gone up to 50% and even more in some countries which clearly shows that there is strong association of childhood obesity with the obstructive sleep apnea and also the leading cause for it.^[2]

Obstructive sleep apnea has been found to be more common in African American children than white children. The odds ratio was measured to be 3 for below the age of 13 years and 1.88 for below the age of 25 years. It may be due to more prevalence of brachycephaly among the Africans than the whites. The Chinese and the Asian children have a more crowded oral cavity and at greater risk of suffering from obstructive sleep apnea disorder.^[3]

When the data for the obstructive sleep apnea was compared for prevalence in the sex then it was found to be skewed towards the male. The male population in children as well as in adults had a higher preponderance then the female population. The ratio ranged from 2-3 to 5-6:1 for males: females. It was hypothesized that the male preponderance is due to the more testosterone levels which result in hypertrophy of the tissues in the oral cavity and is more likely to occur during puberty. Some of the results were also attributed to the fact that females are less likely to report the problem of snoring than that of males.

Conclusion

Obstructive sleep apnea and their symptoms can be present commonly among the children but its diagnosis is rare because of the unavailability of the specific criteria and lack of accurate questionnaires and recall bias of the parents.

The diagnosis for this disorder has been made only in 4 to 11% of the children who have reported to be suffering from its symptoms like snoring. There has been a relative increase in the number of cases in the past few years especially in the younger age group of children and adolescents due to the rise in childhood obesity among them. The condition has a good prognosis if diagnosed early and the treatment is started with CPAP but at the same time, there is an increased risk of complications and decreased quality of life if this condition is diagnosed in childhood or adolescence.

References:

Also Read:

How Common Is Obstructive Sleep Apnea In Children Or Is It A Rare Disease?