title: Prevalence of habitual snoring in children and occurrence of peri-operative adverse events.
abstract: OBJECTIVE
  To describe the prevalence of habitual snoring and examine its association with peri-operative adverse events in children undergoing elective non-cardiac surgery--a relationship that has not been previously characterised.
  
  
  METHODS
  Using a prospective observational design, we studied children aged 6-18 years undergoing elective non-cardiac surgeries at our institution. Trained research assistants collected clinical (including peri-operative adverse events) and anthropometric data on all individuals. Patients were stratified into two classes, habitual snorers and non-snorers. Subsequently, univariate factors associated with snoring were explored and then odds ratios for the occurrence of peri-operative adverse events were calculated from logistic regression after controlling for clinically relevant cofactors.
  
  
  RESULTS
  Among 1102 patients, the prevalence of habitual snoring was 27.3% (28.2% for boys vs. 26.3% for girls). All the measured anthropometric parameters (BMI, waist circumference and neck circumference) were significantly higher in habitual snorers compared with non-snorers. The overall respiratory complication rate was 11.1%. Respiratory adverse events were more frequent in habitual snorers compared with non-snorers (16.9 vs. 8.9%; P < 0.001). Additionally, habitual snoring was associated with longer post-anaesthesia care unit (PACU) stay (114.0 ± 49.6 vs. 103.6 ± 48.9 min; P = 0.002) even after controlling for the occurrence of adverse respiratory events.
  
  
  CONCLUSIONS
  The prevalence of habitual snoring was high in this cohort of paediatric surgical patients. Habitual snoring was associated with some peri-operative adverse events and prolonged PACU stay and should be considered an important symptom in the pre-operative review of children.
authors.affiliation: Section of Pediatric Anesthesiology, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan 48109-0048, USA. onafiu@med.umich.edu
authors.forename: Olubukola O
authors.initials: OO
authors.lastname: Nafiu
authors.forename: Constance C
authors.initials: CC
authors.lastname: Burke
authors.forename: Wilson T
authors.initials: WT
authors.lastname: Chimbira
authors.forename: Ray
authors.initials: R
authors.lastname: Ackwerh
authors.forename: Paul I
authors.initials: PI
authors.lastname: Reynolds
authors.forename: Shobha
authors.initials: S
authors.lastname: Malviya
mesh_terms: D000293:Adolescent; D000762:Anesthesia Recovery Period; D000886:Anthropometry; D015992:Body Mass Index; D002648:Child; D006801:Humans; D016015:Logistic Models; D008297:Male; D009333:Neck / Q000033:anatomy & histology; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*; D012913:Snoring / Q000150:complications*; D055105:Waist Circumference