Risk factors for sleep-disordered breathing in children - Associations with obesity, race, and respiratory problems

This study examined risk factors for sleep-disordered breathing (SDB) in ch ildren and adolescents; specifically, quantifying risk associated with obes ity, race, and upper and lower respiratory problems. Subjects were particip ants in a genetic-epidemiologic study of SDB and included 399 children and adolescents 2 to 18 yr of age, recruited as members of families with a memb er (a proband) with known sleep apnea (31 index families) or as members of neighborhood control families (30 families). SDB was assessed with home ove rnight multichannel monitoring and SDB was defined based on an apnea-hypopn ea index greater than or equal to 10 (moderately affected) or < 5 (unaffect ed). SDB of moderate level was significantly associated with obesity (odds ratio, 4.59; 95% confidence interval [CI], 1.58 to 13.33) and African-Ameri can race (odds ratio, 3.49; 95% CI, 1.56 to 8.32) but not with sex or age. After adjusting for obesity, proband sampling, race and familial clustering , sinus problems and persistent wheeze each independently (of the other) pr edicted SDB. These data suggest the importance of upper and lower respirato ry problems and obesity as risk factors for SDB in children and adolescents . Increased risk in African Americans appears to be independent of the effe cts of obesity or respiratory problems.