title: Obstructive sleep apnea in preschool-aged Japanese children - efficiency of screening using lateral neck radiography.
abstract: Conclusions The prevalence of obstructive sleep apnea (OSA) in preschool-aged children diagnosed by the International Classification of Sleep Disorders (ICSD) version 3 criteria was relatively higher than that diagnosed by ICSD-2. Although the assessment of the upper airway by lateral neck radiography was effective for detecting OSA in this age group, this assessment is not recommended for all children as a screening method because of parental concern related to radiation exposure. Objective This study investigated the prevalence of OSA and the screening capacity of lateral neck radiography in community-based preschool-aged children. Methods Parents of 211 children aged 3-6 years were requested to complete the sleep-related questionnaire. Subjects who agreed to further investigations were invited to undergo home type 3 portable monitoring and clinical examination, including radiography. We estimated the prevalence of OSA and evaluated the detection power of radiography for predicting OSA. Results One hundred and eighty-eight (89.1%) subjects completed the questionnaire and 67 (31.8%) agreed to further examinations. The weighted prevalence was 7.3% and 12.8% by ICSD-2 and 3, respectively. Area under the receiver operator curve for the adenoidal/nasopharyngeal and tonsil/pharyngeal ratios measured using radiography was slightly larger than that for tonsil size graded by visual inspection.
authors.affiliation: a Department of Otorhinolaryngology-Head and Neck Surgery , University of Occupational and Environmental Health , Kitakyushu , Japan ;
authors.forename: Takuro
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: b Department of Sleep Medicine , Shiga University of Medical Science , Otsu , Japan ;
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miyazaki
authors.affiliation: c Sleep Disordered Breathing Center, Ayagawa National Health Insurance Sue Hospital , Ayagawa , Japan ;
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kobayashi
authors.affiliation: d Department of Psychiatry , Shiga University of Medical Science , Otsu , Japan ;
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kadotani
authors.affiliation: d Department of Psychiatry , Shiga University of Medical Science , Otsu , Japan ;
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanemura
authors.affiliation: e Department of Otorhinolaryngology , Japan Community Health Care Organization Shiga Hospital , Otsu , Japan ;
authors.forename: Ichiro
authors.initials: I
authors.lastname: Komada
authors.affiliation: f Department of Otorhinolaryngology , Ohmikusatsu Tokushukai Hospital , Kusatsu , Japan ;
authors.forename: Michiko
authors.initials: M
authors.lastname: Nishikawa
authors.affiliation: g Yoyogi Sleep Disorder Center , Tokyo , Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Okawa
authors.affiliation: a Department of Otorhinolaryngology-Head and Neck Surgery , University of Occupational and Environmental Health , Kitakyushu , Japan ;
authors.forename: Hiroki
authors.initials: H
authors.lastname: Koizumi
authors.affiliation: a Department of Otorhinolaryngology-Head and Neck Surgery , University of Occupational and Environmental Health , Kitakyushu , Japan ;
authors.forename: Shoko
authors.initials: S
authors.lastname: Takeuchi
authors.affiliation: a Department of Otorhinolaryngology-Head and Neck Surgery , University of Occupational and Environmental Health , Kitakyushu , Japan ;
authors.forename: Hideaki
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D017286:Polysomnography; D015995:Prevalence; D011859:Radiography; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000453:epidemiology*
keywords: International Classification of Sleep Disorders; Obstructive sleep apnea; lateral neck radiography; pediatric; type 3 portable monitoring