Obstructive sleep apnea risk and predictors among children in Boston and Lebanon

OBJECTIVES: The aims of our study were to compare the prevalence of obstructive sleep apnea (OSA) and two-dimensional cephalometric measurements between patients in Boston and Lebanon and to investigate the relationship between high-risk subjects and their underlying respiratory condition. MATERIALS AND METHODS: A cross-sectional study was conducted among patients enrolled in different dental treatment centers in Boston and Lebanon. Participants’ medical history, pediatric sleep questionnaire (PSQ), and lateral cephalograms were collected. Sagittal and vertical dimensions of the cranial base, maxilla, mandible, and hyoid bone position were assessed for each patient. RESULTS: 463 children with a mean age of 13.8 ± 2.5 years were included in this study. A binary logistic regression was run to predict a high risk for OSA by the predictors mentioned below. Lebanese children were significantly at higher risk of OSA (OR = 0.05; 95% CI: 0.01–0.24, P < .001), with a prevalence of 17.8% compared to only 0.7% among children in Boston. Age and sex, however, did not contribute significantly ( P > 0.05). ANB ( P = 0.02), GoMe ( P < .001), Wits ( P = 0.02), and MPh ( P < .001) significantly differed between Boston and Lebanon groups, although none could predict a high risk for OSA. Adenoid ( P < .001) and tonsil ( P = 0.019) hypertrophy and nasal septum deviation ( P < .001) were significantly more prevalent among Lebanese, with adenoid ( P = 0.015) and tonsil hypertrophy ( P = 0.01) being significant OSA predictors. CONCLUSIONS: High-risk for OSA subjects were significantly more prevalent among Lebanese children. Cephalometric measurements differed significantly between both groups; however, none was a risk predictor of OSA. Adenoid and tonsil hypertrophy were major risk factors for OSA, and Lebanese patients showed a higher predisposition to these factors.