title: Snoring in 9- to 15-year-old children: risk factors and clinical relevance.
abstract: OBJECTIVE
  Our objective was to investigate the occurrence of snoring in a general population sample of children and to evaluate the association with anthropometric data and clinical findings of oropharynx and nasal airways.
  
  
  METHODS
  A cross-sectional study was conducted with children from primary and secondary schools in Civitavecchia and Viterbo in the Latium region in central Italy. The total sample of the survey included 2439 schoolchildren. A total of 2209 children who were ages 10 to 15 years were selected (response rate: 90.5%) according to their snoring frequency during sleep: never, only with colds, occasionally apart from with colds, often. Children in the last category were defined as habitual snorers. Data were collected by means of questionnaires and clinical examination. A blood sample was collected to determine the concentration of hemoglobin in the blood. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals.
  
  
  RESULTS
  The prevalence of habitual snorers was 5.6%. Boys who were older than 15 years and had a body mass index greater than the 90th percentile were significantly more likely to be snorers. Habitual snoring was strongly associated with decreased nasal patency (rhinitis OR: 2.13; septal deviation OR: 2.75; nasal obstruction OR: 2.20). Children who had undergone adenoidectomy or had markedly enlarged tonsils were at greater risk of being habitual snorers (OR: 4.28 and 5.07, respectively). Last, habitual snorers had a significantly higher concentration of hemoglobin in the blood compared with other children.
  
  
  CONCLUSIONS
  Body weight and nasal and pharynx patency seem to be the main determinants of snoring. The finding of higher values of blood hemoglobin concentration in snorers than in nonsnorers suggests that these children could be experiencing oxyhemoglobin desaturation during sleep. Taking into consideration the relationship between these different risk factors could lead to a better clinical approach to the snoring child.
authors.affiliation: Respiratory Physiology Department, Catholic University, Rome, Italy. gmcorbo@yahoo.com
authors.forename: G M
authors.initials: GM
authors.lastname: Corbo
authors.forename: F
authors.initials: F
authors.lastname: Forastiere
authors.forename: N
authors.initials: N
authors.lastname: Agabiti
authors.forename: R
authors.initials: R
authors.lastname: Pistelli
authors.forename: V
authors.initials: V
authors.lastname: Dell'Orco
authors.forename: C A
authors.initials: CA
authors.lastname: Perucci
authors.forename: S
authors.initials: S
authors.lastname: Valente
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000150:complications; D015992:Body Mass Index; D002648:Child; D003139:Common Cold / Q000150:complications; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012913:Snoring / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires