Abstract Introduction The prevalence of pediatric Habitual snoring (HS, ≥3 nights/week) is highly prevalent among children in the U.S. Although adenotonsillar hypertrophy and elevated body mass index (BMI) are known risk factors for childhood sleep-disordered breathing (SDB), less is known on the contribution of modifiable sociodemographic and environmental factors in community-based populations. We hypothesize that sociodemographic and neighborhood characteristics are independently associated with HS in a large community-based pediatric cohort. Methods Cross-sectional analysis of the Adolescent Brain Cognitive Development (ABCD) cohort study of children aged 9-10 at baseline and on yearly evaluations 1-4. Predictors included sex, race/ethnicity, obesity (BMI percentile 95), environmental tobacco smoke exposure (ETS), and census-tract Childhood Opportunity Index (COI 2.0). HS derived from the Sleep Disturbance Scale for Children and compared to “no snoring” (snoring 0 nights/week). Statistical analyses utilized t-tests, chi-square tests, and stepwise logistic regression models, adjusting for relevant SDB covariates. Results At baseline, among 11,868 children (mean age 9.96±0.62 years), 59% reported no snoring, 34.2% non-habitual snoring, and 6.8% HS. HS prevalence differed by race/ethnicity: 14.3% in NH-Black/AA, 7.9% in NH-Asian, 7.4% in Hispanics and 7.3% in NH-Other, compared to 4.3% NH-Whites (p 0.01). Compared to children with no snoring, HS children were more likely to reside in low-to-very-low COI opportunity neighborhoods (43.9% vs. 25.8%, p 0.01), had higher rates of obesity (33.2% vs 12.4%, p 0.01) and ETS exposure (33.6% vs 19.2%, p 0.01). In multivariable logistic regression models fitted separately for baseline through year 4 (adjusting for baseline sex, obesity, and ETS), low-to-very-low COI consistently predicted higher odds of HS across all time points (OR range 1.57–1.96), in addition to obesity (OR range: 2.68–3.02) and ETS (OR range 1.40–2.00). In models additionally adjusted for race/ethnicity compared to NH-Whites, minority groups demonstrated elevated odds across the majority of time points: NH-Black/AA (OR range 1.84–2.93), NH-Asian (OR range 1.12–3.09), Hispanic (OR range 1.13–1.74), and NH-Other (OR range 1.40–1.73). Conclusion Neighborhood-level characteristics and minority race/ethnicity were independently associated with HS in children. These findings underscore the importance of investigating population-level determinants of pediatric SDB to inform targeted prevention and equitable management. Support (if any) Robert A. Winn Excellence in Clinical Trials Award
Gutierrez et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: