title: Prevalence of obstructive sleep apnea syndrome in a cohort of 1,207 children of southern Italy.
abstract: OBJECTIVE
  To determine the prevalence of sleep-related breathing disturbances in a large cohort of school-aged and preschool-aged children of Southern Italy.
  
  
  METHODS
  This cross-sectional prevalence study was designed in two phases: a screening phase aimed to identify symptomatic children from a cohort of 1,207 by a self-administered questionnaire, and an instrumental phase for the definition of sleep-related disorders.
  
  
  METHODS
  One thousand two hundred seven children were screened by a self-administered questionnaire. There were 612 female children (51%) and 595 male children (mean age, 7.3 years; range, 3 to 11 years). According to answers, children were classified in three groups: nonsnorers, occasional snorers, and habitual snorers. All habitual snoring children underwent a polysomnographic home evaluation, and those with an oxygen desaturation index > 2 were considered for nocturnal polygraphic monitoring (NPM). Children with an apnea/hypopnea index > 3 received a diagnosis of obstructive sleep apnea syndrome (OSAS).
  
  
  RESULTS
  A total of 895 questionnaires (74.2%) were returned and scored; 710 children (79.3%) were identified as nonsnorers, 141 children (15.8%) were identified as occasional snorers, and 44 children (4.9%) were identified as habitual snorers. The percentage of male children who were habitual snorers was higher than the percentage of female children who were habitual snorers (6.1% vs 3.7%, respectively; p < 0.09). OSAS was diagnosed in nine children by NPM.
  
  
  CONCLUSIONS
  The lower limit of prevalence of OSAS in childhood is 1% (95% confidence interval [CI], 0.8 to 1.2). If we add the five children who underwent adenoidectomy and/or tonsillectomy because of worsening clinical condition and the two children who were shown to have evidence of OSAS on domiciliary oximetry, then the prevalence is 1.8% (higher limit of prevalence; 95% CI, 1.6 to 2.0).
authors.affiliation: Department of Pediatrics, Clinica Pediatrica III, University of Bari, Bari, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Brunetti
authors.forename: S
authors.initials: S
authors.lastname: Rana
authors.forename: M L
authors.initials: ML
authors.lastname: Lospalluti
authors.forename: A
authors.initials: A
authors.lastname: Pietrafesa
authors.forename: R
authors.initials: R
authors.lastname: Francavilla
authors.forename: M
authors.initials: M
authors.lastname: Fanelli
authors.forename: L
authors.initials: L
authors.lastname: Armenio
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012913:Snoring / Q000453:epidemiology