Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severity
Abstract Objectives To examine the relationship between neighborhood‐level advantage and severe obstructive sleep apnea (OSA) in children. Methods A retrospective case–control study was conducted on 249 children who underwent adenotonsillectomy and had full‐night polysomnography conducted within 6 m...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-08-01
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| Series: | Laryngoscope Investigative Otolaryngology |
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| Online Access: | https://doi.org/10.1002/lio2.1098 |
| _version_ | 1797738279695548416 |
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| author | Jenny Kim Yann‐Fuu Kou Stephen R. Chorney Ron B. Mitchell Romaine F. Johnson |
| author_facet | Jenny Kim Yann‐Fuu Kou Stephen R. Chorney Ron B. Mitchell Romaine F. Johnson |
| author_sort | Jenny Kim |
| collection | DOAJ |
| description | Abstract Objectives To examine the relationship between neighborhood‐level advantage and severe obstructive sleep apnea (OSA) in children. Methods A retrospective case–control study was conducted on 249 children who underwent adenotonsillectomy and had full‐night polysomnography conducted within 6 months prior. Patients were divided into more or less socioeconomically disadvantaged groups using a validated measure, the area deprivation index (ADI). The primary outcomes were the relationship between the apnea–hypopnea index (AHI) and the presence of severe OSA, and the secondary outcome was residual moderate or greater OSA after tonsillectomy. Results Of the 249 children included in the study, 175 (70.3%) were socially disadvantaged (ADI > 50). The median (interquartile range [IQR]) age was 9.4 (7.3–12.3) years, 129 (51.8%) were male, and the majority were White (151, 60.9%), Black (51, 20.6%), and/or of Hispanic (155, 62.5%) ethnicity. A total of 140 (56.2%) children were obese. The median (IQR) AHI was 8.9 (3.9–20.2). There was no significant difference in the median AHI or the presence of severe OSA between the more and less disadvantaged groups. Severe OSA was found to be associated with obesity (odds ratio [OR] = 3.13, 95% confidence interval [CI] = 1.83–5.34), and residual moderate or greater OSA was associated with older age (OR = 1.20, 95% CI = 1.05–1.38). Conclusions The ADI was not significantly associated with severe OSA or residual OSA in this cohort of children. Although more neighborhood‐level disadvantage may increase the risk of comorbidities associated with OSA, it was not an independent risk factor in this study. Level of Evidence Level 4. |
| first_indexed | 2024-03-12T13:41:31Z |
| format | Article |
| id | doaj.art-bbd8ce8deb864dcab8d2d07d45f136c6 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-03-12T13:41:31Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-bbd8ce8deb864dcab8d2d07d45f136c62023-08-23T18:20:18ZengWileyLaryngoscope Investigative Otolaryngology2378-80382023-08-01841114112310.1002/lio2.1098Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severityJenny Kim0Yann‐Fuu Kou1Stephen R. Chorney2Ron B. Mitchell3Romaine F. Johnson4Department of Otolaryngology University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology University of Texas Southwestern Medical Center Dallas Texas USAAbstract Objectives To examine the relationship between neighborhood‐level advantage and severe obstructive sleep apnea (OSA) in children. Methods A retrospective case–control study was conducted on 249 children who underwent adenotonsillectomy and had full‐night polysomnography conducted within 6 months prior. Patients were divided into more or less socioeconomically disadvantaged groups using a validated measure, the area deprivation index (ADI). The primary outcomes were the relationship between the apnea–hypopnea index (AHI) and the presence of severe OSA, and the secondary outcome was residual moderate or greater OSA after tonsillectomy. Results Of the 249 children included in the study, 175 (70.3%) were socially disadvantaged (ADI > 50). The median (interquartile range [IQR]) age was 9.4 (7.3–12.3) years, 129 (51.8%) were male, and the majority were White (151, 60.9%), Black (51, 20.6%), and/or of Hispanic (155, 62.5%) ethnicity. A total of 140 (56.2%) children were obese. The median (IQR) AHI was 8.9 (3.9–20.2). There was no significant difference in the median AHI or the presence of severe OSA between the more and less disadvantaged groups. Severe OSA was found to be associated with obesity (odds ratio [OR] = 3.13, 95% confidence interval [CI] = 1.83–5.34), and residual moderate or greater OSA was associated with older age (OR = 1.20, 95% CI = 1.05–1.38). Conclusions The ADI was not significantly associated with severe OSA or residual OSA in this cohort of children. Although more neighborhood‐level disadvantage may increase the risk of comorbidities associated with OSA, it was not an independent risk factor in this study. Level of Evidence Level 4.https://doi.org/10.1002/lio2.1098area deprivation indexneighborhood‐level disadvantagepediatric obstructive sleep apneasocioeconomic status |
| spellingShingle | Jenny Kim Yann‐Fuu Kou Stephen R. Chorney Ron B. Mitchell Romaine F. Johnson Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severity Laryngoscope Investigative Otolaryngology area deprivation index neighborhood‐level disadvantage pediatric obstructive sleep apnea socioeconomic status |
| title | Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severity |
| title_full | Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severity |
| title_fullStr | Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severity |
| title_full_unstemmed | Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severity |
| title_short | Assessment of neighborhood‐level disadvantage and pediatric obstructive sleep apnea severity |
| title_sort | assessment of neighborhood level disadvantage and pediatric obstructive sleep apnea severity |
| topic | area deprivation index neighborhood‐level disadvantage pediatric obstructive sleep apnea socioeconomic status |
| url | https://doi.org/10.1002/lio2.1098 |
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