title: Parental history of adenotonsillectomy is associated with obstructive sleep apnea severity in children with snoring.
abstract: OBJECTIVE
  To test the hypothesis that history of adenoidectomy and/or tonsillectomy (AT) in at least 1 of the parents during childhood, is a risk factor for moderate-to-severe obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI] >5 episodes/hour) in the offspring with snoring.
  
  
  METHODS
  Data of children with snoring who were referred for polysomnography over 12 years by primary care physicians were reviewed.
  
  
  RESULTS
  Data of 798 children without history of prior AT, neuromuscular, or genetic disorders or craniofacial abnormalities were analyzed. Of these children, 69.3% had tonsillar hypertrophy, 25.8% were obese, 26.8% had at least 1 parent with history of AT, and 22.1% had AHI >5 episodes/hour. Parental history of AT was significantly associated with moderate-to-severe OSA (logit model including sex, tonsillar hypertrophy, obesity, and physician-diagnosed wheezing; OR [95% CI], 1.70 [1.18-2.46]; P < .01). When significant variables from the logit model (tonsillar hypertrophy, obesity, parental history of AT) were considered independently or in combination, tonsillar hypertrophy combined with history of AT in at least 1 of the parents had high specificity (84.4%) and the highest positive likelihood ratio (1.78) for identifying children with AHI >5 episodes/hour.
  
  
  CONCLUSIONS
  Among children with snoring who are referred for polysomnography by primary care physicians, those with tonsillar hypertrophy and parental history of AT have increased risk of moderate-to-severe OSA and represent 1 of the subgroups that should be prioritized for a sleep study in settings with limited resources.
authors.affiliation: Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece.
authors.forename: Emmanouel I
authors.initials: EI
authors.lastname: Alexopoulos
authors.affiliation: Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Charitos
authors.affiliation: Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece; Pediatric Pulmonology Unit, Sleep Disorders Laboratory, First Department of Pediatrics, School of Medicine, University of Athens and Aghia Sophia Children's Hospital, Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Malakasioti
authors.affiliation: Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Varlami
authors.affiliation: Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Gourgoulianis
authors.affiliation: Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece; Biostatistics Research Center, The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, School of Medicine, Tufts University, Boston, MA.
authors.forename: Elias
authors.initials: E
authors.lastname: Zintzaras
authors.affiliation: Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece; Pediatric Pulmonology Unit, Sleep Disorders Laboratory, First Department of Pediatrics, School of Medicine, University of Athens and Aghia Sophia Children's Hospital, Athens, Greece. Electronic address: kaditia@hotmail.com.
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Kaditis
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D016017:Odds Ratio; D010290:Parents; D017286:Polysomnography / Q000379:methods; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology*; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data