Seasonal variation in a clinical referral pediatric cohort at risk for obstructive sleep apnea

Objective: The present study was carried to examine the hypothesis that the severity of obstructive sleep apnea (OSA) in a clinical referral population of children would manifest seasonal variability in their polysomnographic findings.

Methods: The study population comprised consecutive children referred for evaluation of habitual nighttime snoring, parentally witnessed apnea during sleep, and difficult or noisy breathing during sleep. A total of 554 children were identified as eligible and underwent full-night polysomnography (PSG). Monthly fluctuation patterns in PSG measures were assessed in 2 age groups (<6 and ≥ 6 years old).

Results: In the younger group, the lowest AHI was found in the month of August (9.5 ± 1.7/hrTST) while December emerged as the month with the lowest AHI for the older group (8.7 ± 2.3/hrTST). The highest AHI was in January (24.8 ± 7.5/hrTST) in the group ≥ 6 years old, and in March (32.7 ± 6.9/hrTST) in the younger group.

Conclusion: Seasonal changes are present in children with clinically symptomatic OSA and differ among younger and older children, with global trends toward improved AHI during summer, especially in younger children. Future studies should be conducted to define a "correction factor" for the month of PSG assessment that will enable accurate decision making when evaluating symptomatic children with habitual snoring.