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Multicenter Study
. 2022 Feb 1;18(2):637-645.
doi: 10.5664/jcsm.9494.

Socioeconomic inequalities in pediatric obstructive sleep apnea

Ji Woon Park  1   2 , Mona M Hamoda  1 , Fernanda R Almeida  1 , Zitong Wang  3   4 , David Wensley  5 , Bassam Alalola  1   6   7 , Mohammed Alsaloum  1   7   8 , Yasue Tanaka  1   9 , Nelly T Huynh  10   11 , Annalijn I Conklin  3   12
Affiliations
Multicenter Study

Socioeconomic inequalities in pediatric obstructive sleep apnea

Ji Woon Park et al. J Clin Sleep Med. .

Abstract

Study objectives: To examine the association between multiple measures of socioeconomic status (SES) and objectively measured obstructive sleep apnea (OSA) in a Canadian pediatric population.

Methods: This was a cross-sectional study of 188 children (4-17 years, mean age 9.3 ± 3.5 years) prospectively recruited from two hospital sleep clinics in Canada, using multivariable-adjusted linear and logistic regression of five measures of SES including parental education, income, social class, geographic location, and perceived SES based on the MacArthur Scale of Subjective Social Status, assessed in relation to four polysomnographic OSA variables including apnea-hypopnea index, apnea index, mean oxygen saturation level, and oxygen desaturation index.

Results: Overall, low household-level SES appeared to be associated with both frequency (apnea index ≥ 1 events/h) and severity (apnea-hypopnea index ≥ 5 events/h) of OSA in children, with maternal education showing the most consistent and significant associations. Specifically, children with mothers reporting less than high school education had nearly three times the odds of having OSA after controlling factors including body mass index (odds ratio 2.96 [95% confidence interval, 1.05-8.37]), compared to university-educated participants. Consistent associations were also observed for geographic location with less frequency and severity of OSA among nonurban children. Perceived SES was minimally inversely associated with our outcomes.

Conclusions: This cross-sectional, multicenter study demonstrated that SES factors are linked to the occurrence and severity of OSA in children. Results indicated the need to incorporate the screening of SES in the diagnostic process of pediatric OSA to provide more targeted intervention and patient-centered care.

Citation: Park JW, Hamoda MM, Almeida FR, et al. Socioeconomic inequalities in pediatric obstructive sleep apnea. J Clin Sleep Med. 2022;18(2):637-645.

Keywords: obstructive sleep apnea; pediatric; polysomnography; socioeconomic status.

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Conflict of interest statement

All authors have seen and approved the manuscript. Work for this study was performed at the Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Child and Family Research Institute, Children’s and Women’s Health Centre of British Columbia, and Faculty of Dental Medicine, Université de Montréal. The University of Montreal and University of British Columbia received funding from Sick Kids Foundation FAS# F15-01212. The authors report no conflicts of interest.

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