Snoring and obstructive sleep apnea in Thai school-age children : Prevalence and predisposing factors

Snoring and obstructive sleep apnea in Thai school-age children : Prevalence and predisposing factors
การนอนกรนและภาวะหยุดหายใจจากทางเดินหายใจอุดตันในเด็กวัยเรียน

Wanaporn Anuntaseree, Asst. Prof., D. of Pediatrics, F. of Medicine, PSU.
Korpong Rookkapan, D. of Otolaryngology, F. of Medicine, PSU.
Surachai Kuasirikul, Asst. Prof., D. of Psychiatry, F. of Medicine, PSU.
Paramee Thongsuksai, Asst. Prof., D. of Pathology, F. of Medicine, PSU.
Corresponding e-mail : awanapor@ratree.psu.ac.th
Grant : Prince of Songkla University
Published : Research Report
Key words : snoring, obstructive sleep apnea, school-age children, allergic rhinitis, adenotonsillar hypertrophy, obesity, passive smoking

The prevalence of habitual snoring and its associations with tonsillar size, allergic rhinitis, obesity, and parental smoking as well as the lower limit of OSAS prevalence were studied. A sample of 1,142 children aged 6-13 years (mean 7.25ฑ0.58) from seven randomly-selected schools in Hat Yai, Southern Thailand were enrolled. Eighty-five (8.5%) of the children were habitual snorers; the prevalence was the same in boys and girls. Significant and independent association was present between snoring and allergic rhinitis with an odds ratio of 5.27; 95% CI 1.57-17.77. The odds ratio was significantly increased to 2.65; CI 1.31-5.39, 5.72; CI 2.67-12.25 and 11.06; CI 1.91-63.84 in children with tonsillar size of 2+, 3+ and 4+ respectively. Of the eighty-five habitual snorers, sixty-nine could be contacted by telephone call or by hospital visit. Eight of these were reported to have at least one of the following symptoms : difficulty breathing during sleep, stop breathing at night, restless sleeping and frequent awakening, sleeping with the head tipped back and a tendency to breath through the mouth rather than the nose. The polysomnographic studies in these eight children demonstrated an apnea/hypopnea index of 0.6-4.7 per hour. Seven children met the criteria for OSAS. Thus our estimation of the lower limit of OSAS prevalence among the Thai school-age children was 7/1008 (0.69%).

Conclusion, we have shown that the prevalence of habitual snoring and the lower limit of prevalence of OSAS in a sample of Asian school-age children in Southern Thailand were 8.5 and 0.69% respectively, which was similar to that from western populations. An association of snoring with tonsillar size or allergic rhinitis was demonstrated. All but one of the snoring children with sleep related symptoms had OSAS, but all were mild cases.

BACK