Prevalence and Correlates of Childhood Sleep Apnea
Condition: Lung Diseases; Sleep Apnea Syndromes
MeSH terms: Sleep Apnea Syndromes; Lung Diseases
Study type: Observational

Summary: 
      To determine if there are anatomic and physical characteristics that distinguish
      pre-adolescent children with sleep disordered breathing and if the sleep disordered breathing
      is associated with adverse effects on school and neurocognitive performance.
    

Detailed description: 
      BACKGROUND:

      The study is part of an initiative, Obstructive Sleep Apnea in Children, which was released
      in December, 1997 with co-sponsorship from the National Institute of Dental and Craniofacial
      Research and the National Institute of Child Health and Human Development. The goal of the
      initiative is to define abnormalities in airway structure and function responsible for
      obstructive sleep apnea in children, ages 3 to 12, and to identify physiological and clinical
      measures associated with increased morbidity.

      DESIGN NARRATIVE:

      A 3 stage stratified sampling procedure is conducted on pre-adolescent Tucson school children
      between the ages of 6 and 12 years of age. Stratification is performed on the following
      factors:age, ethnicity, gender and snoring status. In the initial phase, 2500 (625 each year)
      pre-adolescent Tucson school children between the ages of 6 and 12 years of age are surveyed
      using a questionnaire designed to elicit symptoms of sleep disordered breathing (SDB)
      including obstructive sleep apnea (OSA). From these data, a subset of 90 snoring and 30
      non-snoring children (500 total) will be recruited each year to have home polysomnography,
      basic anthropometric measurements and a battery of neurocognitive tests performed in order to
      identify a group of children with SDB including OSA and a group without this condition. In
      the third phase of the study, 20 children with SDB and 20 without will be recruited each year
      (80 total) to undergo more intensive anatomic and physiologic testing including cephalometry,
      measurement of upper airway geometry and resistance using acoustic reflection and oscillation
      techniques and control of ventilation studies.

      The intent of the study is to: 1) determine the prevalence of symptoms of SDB in
      pre-adolescent Caucasian and Hispanic children; 2) compare the prevalence of objectively
      measured SDB in pre-adolescent Caucasian and Hispanic children; 3) determine whether there
      are physiologic and anatomic differences among pre-adolescent children who have SDB including
      obstructive sleep apnea and upper airway resistance syndrome (UARS) and those who do not
      during quiet wakefulness; and 4) determine the association between SDB and school
      performance, neuro-cognitive ability and daytime symptoms.

      The study has been extended through November 2008 to to follow a large cohort of
      pre-adolescent children to determine whether untreated sleep apnea is associated with
      identifiable decrements in neurocognitive performance and school performance, as well as
      perturbations of blood pressure and growth, at approximately four years after initial
      enrollment and identification of sleep apnea. The study also aims to identify pre-adolescent
      anthropometric and ethnic variables associated with future development and/or regression of
      sleep apnea .The study secondarily aims to determine whether abnormalities in ventilatory
      drive found in pre-adolescence in children with sleep apnea persist after approximately four
      years of untreated sleep apnea.