Publication related to RSI or an RSI staff member
Neck circumference percentile: A screening tool for pediatric obstructive sleep apnea.
RATIONALE: Large neck circumference (NC) is associated with obstructive sleep apnea (OSA) in adults, especially males. Since NC changes with age and sex, a lack of reference ranges makes neck size difficult to assess as a screening tool in children. METHODS: Using a population-based dataset of 1,913 children, we developed reference ranges for NC by age and sex for children aged 6-17 years. In this study, we collected NC data on 245 children aged 6-17 years presenting to the Children’s Hospital of Eastern Ontario for polysomnography. The association between NC>the 95th percentile and OSA (total apnea-hypopnea-index>5 events/hr and/or obstructive-apnea-index >/= 1 event/hr) was explored. Thresholds of BMI percentile and waist circumference were also examined. RESULTS: Individuals with NC>95th percentile for age and sex had increased risk of OSA (relative risk 1.7 [95% CI 1.0-3.0], P=0.04), compared to those with NC /= 95th percentile gave similar results (relative risk 1.8 [95% CI 1.1-2.9], P=0.02). When examined by sex, the association was significant in males >/= 12 years (relative risk 3.3 [95% CI 1.0-10.4], P=0.04), but not females (P=0.63). Neither BMI >/= 95th percentile nor waist circumference>95th percentile was significant. CONCLUSIONS: Children and youth with NC>95th percentile for age and sex have significantly increased risk of OSA. This effect is significant in males >/= 12 years, whereas BMI is not. NC percentile may be an additional screening tool for OSA in children and youth.
Authors
- Katz, Sherri, Katz S, Division of Respirology, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- Murto, Kimmo, Murto K,
- Barrowman, Nicholas, Barrowman N,
- Clarke, Janine, Clarke J,
- Hoey, Lynda, Hoey L,
- Momoli, Franco, Momoli F,
- Laberge, Robert, Laberge R,
- Vaccani, Jean-Philippe, Vaccani JP,
RATIONALE: Large neck circumference (NC) is associated with obstructive sleep apnea (OSA) in adults, especially males. Since NC changes with age and sex, a lack of reference ranges makes neck size difficult to assess as a screening tool in children. METHODS: Using a population-based dataset of 1,913 children, we developed reference ranges for NC by age and sex for children aged 6-17 years. In this study, we collected NC data on 245 children aged 6-17 years presenting to the Children's Hospital of Eastern Ontario for polysomnography. The association between NC>the 95th percentile and OSA (total apnea-hypopnea-index>5 events/hr and/or obstructive-apnea-index >/= 1 event/hr) was explored. Thresholds of BMI percentile and waist circumference were also examined. RESULTS: Individuals with NC>95th percentile for age and sex had increased risk of OSA (relative risk 1.7 [95% CI 1.0-3.0], P=0.04), compared to those with NC /= 95th percentile gave similar results (relative risk 1.8 [95% CI 1.1-2.9], P=0.02). When examined by sex, the association was significant in males >/= 12 years (relative risk 3.3 [95% CI 1.0-10.4], P=0.04), but not females (P=0.63). Neither BMI >/= 95th percentile nor waist circumference>95th percentile was significant. CONCLUSIONS: Children and youth with NC>95th percentile for age and sex have significantly increased risk of OSA. This effect is significant in males >/= 12 years, whereas BMI is not. NC percentile may be an additional screening tool for OSA in children and youth.
