Neck circumference percentile: a screening tool for pediatric obstructive sleep apnea
Pediatric pulmonology, 2015•Wiley Online Library
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 …
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 …
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.
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