Clinical predictors of sleep disordered breathing in children at moderate altitude.
BACKGROUND
Validated clinical indicators of sleep disordered breathing (SDB) in children are scarce and none generated at moderate altitude where hypoxemic complications could be frequent and oximetry evaluation might be very efficient.


METHODS
A total of 158 children consecutively referred to a sleep clinic in Mexico City (2240 m) for suspected sleep apnea underwent clinical evaluation and nocturnal monitoring of pulse oximetry, snoring and body position.


RESULTS
Mean age was 4.9 years (SD 2.5) and 68.4% were males. A total of 84% of children were found with more than five desaturations per hour (>/=4%) while 63% and 34% had more than 10 and 20 desaturations, respectively. Based on logistic regression models, age </=5 was the only predictor for more than five desaturations per hour (OR 4.5, 95% CI 1.6-12.6). Clinical predictors of more than 10 desaturations were age </=5 years (OR 4.0, 95% CI 1.9-8.8), obesity (OR 3.5, 95% CI 1.3-9.1), enlarged tonsils (OR 3.5, 95% CI 1.6-8.1) and male gender (OR 2.4, 95% CI 1.1-5.2). Witnessed apneas (OR 3.1, 95% CI 1.7-7.0), age </=5 years (OR 2.6; 95% CI 1.2-5.5), obesity (OR 2.4, 95% CI 1.0-5.6) and simultaneous enlargement of adenoids and tonsils predicted more than 20 desaturations (OR 2.4; 95% CI 1.0-5.8).


CONCLUSIONS
Age, gender, witnessed apneas, enlarged tonsils or adenoids and obesity were clinical predictors of SDB in children referred to a sleep clinic at moderate altitude.
Vázquez
Juan Carlos
JC
Departamento de Fisiología Respiratoria y Laboratorio de Sueño, Instituto Nacional de Enfermedades Respiratorias (INER), Secretaría de Salud (SSA), Mexico City, Mexico. jcvaz@mexis.com
Montes
Francisco Marentes
FM
Rivera
Carlos Aboitiz
CA
Vargas
Sonia Meza
SM
Pérez-Padilla
Rogelio
R
D000234:Adenoids / Q000473:pathology; D000367:Age Factors; D000531:Altitude; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D010092:Oximetry; D014066:Palatine Tonsil / Q000473:pathology; D012119:Respiration; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012890:Sleep / Q000502:physiology*; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*