Childhood Sleep Disordered Breathing: Epidemiology, Health Implications and Surgical Management in Jos, Nigeria.

ABSTRACT

Background; Sleep-disordered breathing, a concept in Sleep Medicine, has been reported among causes of sudden death from consequences of obstructive sleep apnea on the cardiopulmonary system and brain, frequently under-recognized. This study aimed to evaluate its epidemiology, health implications, and treatment outcome in our setting. Method: A cross-sectional study of consenting childhood sleep-disordered breathing participants over a two-year period; August 2017-July 2019, at the Jos University Teaching Hospital in Nigeria. Results; We analyzed 83 participants with sleep-disordered breathing, accounting for 2.8%  of the 2,994 childhood ear, nose, and throat consultations, with a male: female ratio of 1.9:1. Their ages ranged from 9 months to 18 years. Eighty three (100.0%) participants had snoring, 23(27.7%) noisy breathing, 10(12.1%) obstructive sleep apnoea and 7(8.4%) obstructive sleep apnoea syndrome. The major risk factor for sleep-disordered breathing was obstructive adenotonsillar hypertrophy; 75(90.4%). Cardiopulmonary complications; 23(27.7%) were the most frequent among participants. Therapy was surgical with primary post-tonsillectomy hemorrhage in 2.4% of participants with a median blood loss of 30.0mls and interquartile range of 25.0ml. There was a positive correlation between Brodsky’s tonsil grade and volume of the surgical specimens (r = 0.388, p = 0.0001). Complete resolution of symptoms was recorded in 79(95.2%) cases. Conclusion. Childhood sleep-disordered breathing is not uncommon with snoring as the most frequent feature. Obstructive sleep apnoea syndrome which correlates with snoring severity accounted for half of obstructive sleep apnoea patients. Cardiopulmonary complications are common, making comprehensive pre-operative evaluation necessary to avoid surgical adverse events.