title: Prevalence and persistence of sleep disordered breathing symptoms in young children: a 6-year population-based cohort study.
abstract: OBJECTIVE
  To describe the prevalence, persistence, and characteristics associated with sleep disordered breathing (SDB) symptoms in a population-based cohort followed from 6 months to 6.75 years.
  
  
  METHODS
  Avon Longitudinal Study of Parents and Children (ALSPAC).
  
  
  METHODS
  England, 1991-1999.
  
  
  METHODS
  12,447 children in ALSPAC with parental report of apnea, snoring, or mouth-breathing frequency on any one of 7 questionnaires.
  
  
  METHODS
  Symptom prevalence rates-assessed as "Always" and "Habitually"-are reported at 0.5, 1.5, 2.5, 3.5, 4.75, 5.75, and 6.75 years of age. The proportion of children in whom symptoms develop, persist or abate between observation points is reported. Exploratory multivariate analyses identified SDB risk factors at 1.5, 4.75, and 6.75 years.
  
  
  RESULTS
  The prevalence of apnea ("Always") is 1%-2% at all ages assessed. In contrast, snoring "Always" ranges from 3.6% to 7.7%, and snoring "Habitually" ranges from 9.6% to 21.2%, with a notable increase from 1.5- 2.5 years. At 6 years old, 25% are habitual mouth-breathers. The "Always" and "Habitual" incidence of each symptom between time points is 1%-5% and 5%-10%, respectively. In multivariate analyses of combined symptoms, socioeconomic factors have stronger, more persistent effects upon increased SDB risk than gestational age, gender, or race (aside from 1.5 years); adenoidectomy decreases risk by 40%-50%.
  
  
  CONCLUSIONS
  This is the first natural history study of the primary symptoms of SDB across a key 6-year period in the development of SDB symptoms. Snoring rates are higher and spike earlier than previously reported. Symptoms are dynamic, suggesting the need for early and continued vigilance in early childhood.
authors: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY 11461 , USA. karen.bonuck@einstein.yu.edu
authors: Karen A
authors: KA
authors: Bonuck
authors: Ronald D
authors: RD
authors: Chervin
authors: Timothy J
authors: TJ
authors: Cole
authors: Alan
authors: A
authors: Emond
authors: John
authors: J
authors: Henderson
authors: Linzhi
authors: L
authors: Xu
authors: Katherine
authors: K
authors: Freeman
mesh_terms: D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D012923:Social Class