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Neck circumference percentile: A screening tool for pediatric obstructive sleep apnea
Author(s) -
Katz Sherri,
Murto Kimmo,
Barrowman Nicholas,
Clarke Janine,
Hoey Lynda,
Momoli Franco,
Laberge Robert,
Vaccani JeanPhilippe
Publication year - 2015
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23003
Subject(s) - medicine , percentile , waist , body mass index , polysomnography , obstructive sleep apnea , population , circumference , pediatrics , demography , apnea , environmental health , statistics , mathematics , geometry , sociology
Summary Rationale Large neck circumference (NC) is associated with obstructive sleep apnea (OSA) in adults, especially males. Since NC changes with age and sex, a lack of reference ranges makes neck size difficult to assess as a screening tool in children. Methods Using a population‐based dataset of 1,913 children, we developed reference ranges for NC by age and sex for children aged 6–17 years. In this study, we collected NC data on 245 children aged 6–17 years presenting to the Children's Hospital of Eastern Ontario for polysomnography. The association between NC > the 95th percentile and OSA (total apnea‐hypopnea‐index > 5 events/hr and/or obstructive‐apnea‐index ≥ 1 event/hr) was explored. Thresholds of BMI percentile and waist circumference were also examined. Results Individuals with NC > 95th percentile for age and sex had increased risk of OSA (relative risk 1.7 [95% CI 1.0–3.0], P = 0.04), compared to those with NC ≤ 95th percentile. BMI ≥ 95th percentile gave similar results (relative risk 1.8 [95% CI 1.1–2.9], P = 0.02). When examined by sex, the association was significant in males ≥12 years (relative risk 3.3 [95% CI 1.0–10.4], P = 0.04), but not females ( P = 0.63). Neither BMI ≥ 95th percentile nor waist circumference > 95th percentile was significant. Conclusions Children and youth with NC > 95th percentile for age and sex have significantly increased risk of OSA. This effect is significant in males ≥12 years, whereas BMI is not. NC percentile may be an additional screening tool for OSA in children and youth. Pediatr Pulmonol. 2015; 50:196–201. © 2014 Wiley Periodicals, Inc.