Gokdemir Yasemin, Civelek Ersoy, Cakir Banu, Demir Ahmet, Kocabas Can Naci, Ikizoglu Nilay Bas, Karakoc Fazilet, Karadag Bulent, Ersu Refika
Department of Pediatric Pulmonology, School of Medicine, Marmara University, Fevzi Cakmak mah. Mimar Sinan Cad. No:41 Ust Kaynarca Pendik, Istanbul, Turkey.
Department of Pediatric Allergy & Immunology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey.
Sleep Breath. 2021 Jun;25(2):915-922. doi: 10.1007/s11325-020-02206-x. Epub 2020 Oct 8.
Sleep-disordered breathing (SDB) in primary school children is a significant problem, yet its prevalence is not well known outside large urban settings. Information on the burden and risk factors of SDB in children could be used to improve resource allocation when providing care across a large country. The objectives of this study were to assess the prevalence of SDB among school-aged children comparing rural and urban settings, and to investigate associated risk factors.
In this cross-sectional study, a random sample of primary school students in Turkey were selected from urban and rural areas and data were collected using the Pediatric Sleep Questionnaire, asthma, and allergic rhinitis questionnaires completed by the parents.
Questionnaires were collected from a total of 139 schools from 58 provinces. A total of 11,013 students were contacted, and 9045 (73%) completed the study. There was no difference in the prevalence of SDB between rural and urban settings (16% vs. 15%, p = 0.612). Multivariate logistic regression analysis revealed that current wheezing, current rhinoconjunctivitis, being overweight, parental snoring, and current mold at home were significant risk factors for SDB in both rural and urban children. Current tobacco smoke exposure (OR = 1.48, 95%CI = 1.19-1.85), near roadway air pollution exposure (OR = 1.40, 95%CI = 1.108-1.791), and mold at home in the first year of life (OR = 1.68, 95%CI = 1.26-2.23) were associated with SDB in urban children. History of maternal/paternal adenotonsillectomy was a significant predictor of SDB in the rural setting (OR = 1.63, 95%CI = 1.12-2.39).
The prevalence of SDB is high in children living in both settings but associated risk factors may vary. Children residing in rural areas should also be screened for sleep-disordered breathing during routine health visits.
小学儿童睡眠呼吸障碍（SDB）是一个重大问题，但在大城市以外地区其患病率尚不为人所知。有关儿童SDB负担和风险因素的信息可用于在一个大国提供医疗服务时改善资源分配。本研究的目的是评估学龄儿童中SDB的患病率，并比较农村和城市地区的情况，同时调查相关风险因素。
在这项横断面研究中，从土耳其城市和农村地区随机抽取小学生样本，并通过家长填写的儿童睡眠问卷、哮喘问卷和过敏性鼻炎问卷收集数据。
共从58个省份的139所学校收集了问卷。总共联系了11013名学生，其中9045名（73%）完成了研究。农村和城市地区SDB的患病率没有差异（16%对15%，p = 0.612）。多因素逻辑回归分析显示，当前喘息、当前鼻结膜炎、超重、父母打鼾以及家中当前有霉菌是农村和城市儿童SDB的重要风险因素。当前接触烟草烟雾（OR = 1.48，95%CI = 1.19 - 1.85）、接触道路附近空气污染（OR = 1.40，95%CI = 1.108 - 1.791）以及出生后第一年家中有霉菌（OR = 1.68，95%CI = 1.26 - 2.23）与城市儿童的SDB相关。父母一方有腺样体扁桃体切除术病史是农村地区SDB的重要预测因素（OR = 1.63，95%CI = 1.12 - 2.39）。
两种环境下生活的儿童中SDB患病率都很高，但相关风险因素可能有所不同。农村地区的儿童在常规健康检查时也应进行睡眠呼吸障碍筛查。
