Background: Prematurity is a known risk factor for SDB at school age, but its impact on sleep quality and SDB prevalence in children <2 years remains unclear.
Methods: Children ≤24 months clinically referred for overnight polysomnography (PSG) at Hadassah Medical Center and the University of Chicago between 2014-2018 were included. We excluded children with genetic syndromes. PSG results were compared between term (TERM) and premature (<37 weeks- PRETERM) born children.
Results: 101 children were included (mean age 15.1 months, 1-24), with 27 born PRETERM (mean gestational age 28 (24-34) weeks). SPO2 while awake was 93% (71%-99%) in all children. PRETERM were younger at time of PSG (11.6 months corrected vs 16.4 in TERM, p<0.001), exhibited increased arousal index (PRETERM 9.4 vs 6.3 events/hr in TERM, p=0.03), increased time awake after sleep onset (PRETERM 11.6 vs 0.3 minutes in TERM, p=0.05) and increased REM% (15% vs 11%, p=0.016). Using cut-off of AHI≥5/hr, PRETERM had increased odds of SDB (age and gender adjusted) - OR of 3.4 (CI95%: 1.2-9.3, p=0.017). Gestational age was the only predictor for SDB in this cohort, with every additional week of gestation reducing the odds for SDB by 12%.
Conclusions: Although retrospective and based on a clinical referral cohort, current findings underscore the importance of prematurity antecedents as a risk factor for SDB in young symptomatic children under the age of 2 years referred for PSG. Awareness is especially important as SDB in this age group often has a non-specific presentation (e.g. FTT). Thus, a history of prematurity should increase awareness to the possibility of SDB, and future studies focused on improved estimates of the prevalence of SDB among non-referral children under 2 year appear warranted.
Correspondence: Alex Gileles-Hillel, alexgi@hadassah.org.il
Financial support: DG is supported by NIH grant HL130984.
