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VOLUME 21 , ISSUE 9 ( September, 2020 ) > List of Articles

ORIGINAL RESEARCH

Prevalence of Sleep-disordered Breathing and its Association with Obesity among Saudi Schoolchildren

Maen Zreaqat, Rozita Hassan, Ab Rani Samsudin, Yasser Stas

Keywords : Obesity, Pediatric sleep questionnaire, Sleep-disordered breathing

Citation Information : Zreaqat M, Hassan R, Samsudin AR, Stas Y. Prevalence of Sleep-disordered Breathing and its Association with Obesity among Saudi Schoolchildren. J Contemp Dent Pract 2020; 21 (9):1022-1026.

DOI: 10.5005/jp-journals-10024-2908

License: CC BY-NC 4.0

Published Online: 21-10-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: Epidemiological studies of sleep disturbances are essential to promote awareness among families and educational officials and deliver appropriate treatment at a very early timing. The aim of this population-based study was to determine the frequency of sleep-disordered breathing (SDB) symptoms and its association with obesity among schoolchildren in West Saudi Arabia. Materials and methods: This cross-sectional study comprised 2,000 schoolchildren aged 6–12 years. Sleep-disordered breathing symptoms were assessed with Arabic version of Pediatric Sleep Questionnaire (PSQ). Overweight/obesity was evaluated using body mass index (BMI) and their association with SDB was tested using a regression analysis model. Results: Overall, 23% of children were at high risk of SDB. Prevalence of habitual snoring was 15.9% and sleep apnea 4%. Boys were at higher risk of SDB than girls (p = 0.026), while age had no effect (p = 0.254). High-risk SDB had a strong association with sleep symptoms compared to low-risk SDB (p < 0.05). Sleep-disordered breathing increased significantly in overweight and obese children (p = 0.017 and p < 0.001, respectively). Conclusion: Around 23% Saudi schoolchildren are at risk of SDB. Related symptoms were strongly associated with high risk of SDB. Overweight and obesity had a strong and progressive association with SDB. Clinical significance: The results will help in identifying children at high risk of developing SDB and plan for early intervention to avoid the progression of SDB later in life.


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  1. Ohida T, Osaki Y, Doi Y, et al. An epidemiologic study of self-reported sleep problems among Japanese adolescents. Sleep 2004;27(5): 978–985. DOI: 10.1093/sleep/27.5.978.
  2. Alfano CA, Zakem AH, Costa NM, et al. Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents. Depress Anxiety 2009;26(6):503–512.
  3. Taras H, Potts-Datema W. Sleep and student performance at school. J Sch Health 2005;75(7):248–754. DOI: 10.1111/j.1746-1561.2005.tb06685.x.
  4. Ayas NT, Owens RL, Kheirandish-Gozal L. Update in sleep medicine 2014. Am J Respir Crit Care Med 2015;92(4):415–420. DOI: 10.1164/rccm.201503-0647UP.
  5. Jensen ME, Gibson PG, Collins CE, et al. Airway and systemic inflammation in obese children with asthma. Eur Respir J 2013;42(4):1012–1019. DOI: 10.1183/09031936.00124912.
  6. Spruyt K, Molfese DL, Gozal D. Sleep duration, sleep regularity, body weight, and metabolic homeostasis in school-aged children. Pediatrics 2011;127(2):345–352. DOI: 10.1542/peds.2010-0497.
  7. Marcus CL, Brooks LJ, Draper KA, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012;130(3):576–584. DOI: 10.1542/peds.2012-1671.
  8. Jara SM, Benke JR, Lin SY, et al. The association between secondhand smoke and sleep-disordered breathing in children: a systematic review. Laryngoscope 2015;125(1):241–247. DOI: 10.1002/lary.24833.
  9. Brockmann PE, Bertrand P, Castro-Rodriguez JA. Influence of asthma on sleep disordered breathing in children: a systematic review. Sleep Med Rev 2014;18(5):393–397. DOI: 10.1016/j.smrv.2014.01.005.
  10. Beck SE, Marcus CL. Pediatric polysomnography. Sleep Med Clin 2009;4(3):393–406. DOI: 10.1016/j.jsmc.2009.04.007.
  11. Traeger N, Schultz B, Pollock AN, et al. Polysomnographic values in children 2 to 9-years-old: additional data and review of the literature. Pediatr Pulmonol 2005;40(1):22–30. DOI: 10.1002/ppul.20236.
  12. Corbo GM, Forastiere F, Agabiti N, et al. Snoring in 9- to 15-year-old children: risk factors and clinical relevance. Paediatrics 2001;108(5):1149–1154. DOI: 10.1542/peds.108.5.1149.
  13. Ersu R, Arman AR, Save D, et al. Prevalence of snoring and symptoms of sleep-disordered breathing in primary school children in Istanbul. Chest J 2004;126(1):19–24. DOI: 10.1378/chest.126.1.19.
  14. Rudnick EF, Walsh JS, Hampton MC, et al. Prevalence and ethnicity of sleep-disordered breathing and obesity in children. Otolaryngol Head Neck Surg 2007;137(6):878–882. DOI: 10.1016/j.otohns.2007. 08.002.
  15. Redline S, Tishler PV, Schluchter M, et al. Risk factors for sleep-disordered breathing in children. associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med 1999;159(5 Pt 1):1527–1532. DOI: 10.1164/ajrccm.159.5.9809079.
  16. Li KK, Kushida C, Powell NB, et al. Obstructive sleep apnea syndrome: a comparison between far-east asian and white men. Laryngoscope 2000;110(10 Pt 1):1689–1693. DOI: 10.1097/00005537-200010000-00022.
  17. Al-Hussaini A, Bashir MS, Khormi M, et al. Overweight and obesity among saudi children and adolescents: where do we stand today? Saudi J Gastroenterol 2019;25(4):229–235. DOI: 10.4103/sjg.SJG_617_18.
  18. World Health Organization http://www.who.int/substance_abuse/research_tools/translation/en/. Accessed 21 Oct 2014.
  19. CDC. About BMI for children and teens. Available at: http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmihtml.
  20. Chervin RD, Hedger K, Dillon JE, et al. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med 2000;1(1):21–32. DOI: 10.1016/S1389-9457(99)00009-X.
  21. De Luca Canto G, Singh V, Major MP, et al. Diagnostic capability of questionnaires and clinical examinations to assess sleep-disordered breathing in children: a systematic review and meta-analysis. J Am Dent Assoc 2014;145(2):165–178. DOI: 10.14219/jada.2013.26.
  22. Reuveni H, Simon T, Tal A, et al. Health care services utilization in children with obstructive sleep apnea syndrome. Pediatrics 2002;110(1 Pt 1):68–72. DOI: 10.1542/peds.110.1.68.
  23. BaHammam A, AlFaris E, Shaikh S, et al. Prevalence of sleep problems and habits in a sample of saudi primary school children. Ann Saudi Med 2006;26(1):7–13. DOI: 10.5144/0256-4947.2006.7.
  24. Wang G, Xu G, Liu Z, et al. Sleep patterns and sleep disturbances among chinese school-aged children: prevalence and associated factors. Sleep Med 2013;14(1):45–52. DOI: 10.1016/j.sleep.2012. 09.022.
  25. Kaditis AG, Finder J, Alexopoulos EI, et al. Sleep-disordered breathing in 3,680 greek children. Pediatr Pulmonol 2004;37(6):499–505. DOI: 10.1002/ppul.20002.
  26. Schlaud M, Urschitz MS, Urschitz-Duprat PM, et al. The german study on sleep-disordered breathing in primary school children: epidemiological approach, representativeness of study sample, and preliminary screening results. Paediatr Perinat Epidemiol 2004;18(6):431–440. DOI: 10.1111/j.1365-3016.2004.00589.x.
  27. Kuehni CE, Strippoli MP, Chauliac ES, et al. Snoring in preschool children: prevalence, severity and risk factors. Eur Respir J 2008;31(2):326–333. DOI: 10.1183/09031936.00088407.
  28. Li AM, Au CT, So HK, et al. Prevalence and risk factors of habitual snoring in primary school children. Chest 2010;138(3):519–527. DOI: 10.1378/chest.09-1926.
  29. Brunetti L, Rana S, Lospalluti ML, et al. Prevalence of obstructive sleep apnea syndrome in a cohort of 1207 children of southern Italy. Chest J 2001;120(6):1930–1935. DOI: 10.1378/chest.120.6.1930.
  30. Petry C, Pereira MU, Pitrez PM, et al. The prevalence of symptoms of sleep-disordered breathing in Brazilian schoolchildren. J Pediatr (Rio J) 2008;84(2):123–129. DOI: 10.1590/S0021-75572008000200006.
  31. Gill AI, Schaughency E, Galland BC. Prevalence and factors associated with snoring in 3-year-olds: early links with behavioral adjustment. Sleep Med 2012;13(9):1191–1197. DOI: 10.1016/j.sleep.2012.05.007.
  32. Ikävalko T, Närhi M, Eloranta AM, et al. Predictors of sleep disordered breathing in children: the PANIC study. Eur J Orthod 2018;40(3): 268–272. DOI: 10.1093/ejo/cjx056.
  33. Kinkead R, Guertin PA, Gulemetova R. Sex, stress and their influence on respiratory regulation. Curr Pharm Des 2013;19(24):4471–4484. DOI: 10.2174/1381612811319240012. Review.
  34. Basoglu OK, Tasbakan MS. Gender differences in clinical and polysomnographic features of obstructive sleep apnea: a clinical study of 2827 patients. Sleep Breath 2018;22(1):241–249. DOI: 10.1007/s11325-017-1482-9.
  35. Verhulst S, Van Gaal L, De Backer W, et al. The prevalence, anatomical correlates and treatment of sleep-disordered breathing in obese children and adolescents. Sleep Med Rev 2008;12(5):339–346. DOI: 10.1016/j.smrv.2007.11.002.
  36. Kohler MJ, van den Heuvel CJ. Is there a clear link between overweight/obesity and sleep disordered breathing in children? Sleep Med Rev 2008;12(5):347–361. DOI: 10.1016/j.smrv.2008.04.008.
  37. Bugalho P, Mendonça M, Barbosa R, et al. The influence of sleep disordered breathing in REM sleep behavior disorder. Sleep Med 2017;37:210–215. DOI: 10.1016/j.sleep.2017.05.012.
  38. Pahkala R, Seppä J, Ikonen A, et al. The impact of pharyngeal fat tissue on the pathogenesis of obstructive sleep apnea. Sleep Breath 2014;18(2):275–282. DOI: 10.1007/s11325-013-0878-4.
  39. Verhulst SL, Franckx H, Van Gaal L, et al. The effect of weight loss on sleep-disordered breathing in obese teenagers. Obesity (Silver Spring) 2009;17(6):1178–1183.
  40. Siegfried W, Siegfried A, Rabenbauer M, et al. Snoring and sleep apnea in obese adolescents: effect of long-term weight loss-rehabilitation. Sleep Breath 1999;3(3):83–88. DOI: 10.1007/s11325-999-0083-7.
  41. Kalra M, Inge T, Garcia V, et al. Obstructive sleep apnea in extremely overweight adolescents undergoing bariatric surgery. Obes Res 2005;13(7):1175–1179. DOI: 10.1038/oby.2005.139.
  42. Sadeh A, Gruber R, Raviv A. Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Dev 2002;73(2): 405–417. DOI: 10.1111/1467-8624.00414.
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