Key points are not available for this paper at this time.
Abstract Introduction Obstructive sleep apnea (OSA) gender dimorphism in the pediatric population has not been elucidated, while there has been a paucity in studies with adequate representation of adolescents. We hypothesize that OSA prevalence in adolescents undergoing polysomnography (PSG) is higher among male sex subjects than their female peers, even after adjusting for body mass index and other covariates. Methods Retrospective review of adolescents 11 to 18 years old who underwent a PSG at Rady Children’s Hospital between October 2016 and April 2022. Exclusion criteria: craniofacial and chromosomal anomalies, and neuromuscular disorders. Demographic characteristics included sex, age, BMI percentile, median income. The obstructive apnea hypopnea index (OAHI) was obtained from the PSG data. Moderate-Severe OSA was defined as OAHI³5 events/hour. Statistical analyses included chi-square tests, two sample t tests and non-parametric tests. Logistic regression was used for analysis of moderate-severe OSA and relevant predictor variables (age, sex, income and race/ethnicity) Results 1745 adolescents with a mean age of 14.1±2.1 years were included, 56.1% were males and 43.9% were female. 58.2% Hispanic, 24.1% NH-Whites, 4.3% NH-Asians/Pacific Islander (Asian/PI), 4.2% NH-Blacks/African American (Black/AA) and 6.6% NH-Other. Male sex adolescents had higher OAHI (median 4.2 IQR, 1.6-13.7 vs median 1.9 IQR, 0.7-5.6, higher moderate to severe OSA than females (44.9% vs 27.2%, p-value 0.05) and higher BMI percentiles (median 97.5 IQR, 82.1-99.2 vs median 95.1 IQR, 73.9-98.5, p-value 0.01). Univariate logistic regression identified higher odds of moderate-severe OSA in Males (OR: 2.18, 95% CI: 1.78-2.66) compared to their female peers. This association persisted (OR: 2.24, 95% CI: 1.81-2.76) even after simultaneous adjustment for age, BMI percentile and median income. Finally, when stratifying by sex, we identified that Hispanic ethnicity (OR: 1.76, 95% CI: 1.19, 2.60) and NH-Asian race (OR: 2.36, 95% CI: 1.21, 4.59) were associated with increased odds of moderate-severe OSA only among males but not females, when compared to their NH-White peers. Conclusion In a sleep laboratory population, we identified higher moderate-severe OSA prevalence in male adolescents compared to females even when accounting for BMI and other relevant covariates. In addition, we found novel ethnic/racial disparities within the male sex population. Support (if any) NIMHD 1P50MD017344 and OT2 HL161847.
Gutierrez et al. (Sat,) studied this question.