Study Objectives:

To examine the association between multiple measures of socioeconomic status (SES) and objectively measured obstructive sleep apnea (OSA) in a Canadian pediatric population.

Methods:

Cross-sectional study of 188 children (4-17 years, mean age 9.3±3.5) prospectively recruited from two hospital sleep clinics in Canada, using multivariable-adjusted linear and logistic regression of five measures of SES including parental education, income, social class, geographic location, and perceived SES based on the MacArthur Scale of Subjective Social Status was assessed in relation to four polysomnographic OSA variables including apnea-hypopnea index (AHI), apnea index (AI), mean oxygen saturation level, and oxygen desaturation index.

Results:

Overall, low household-level SES appeared to be associated with both frequency (AI≥1) and severity (AHI≥5) of OSA in children, with maternal education showing the most consistent and significant associations. Specifically, children with mothers reporting less than high school education had nearly three times the odds of having OSA after controlling factors including BMI (Odds ratio [OR] 2.96 [95% CI: 1.05, 8.37]), compared to university-educated participants. Consistent associations were also observed for geographic location with less frequency and severity of OSA among non-urban children. Perceived SES was minimally inversely associated with our outcomes.

Conclusions:

This cross-sectional, multi-center study demonstrated that SES factors are linked to the occurrence and severity of OSA in children. Results indicated the need to incorporate the screening of SES in the diagnostic process of pediatric OSA to provide more targeted intervention and patient-centered care.

中文翻译：

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儿童阻塞性睡眠呼吸暂停的社会经济不平等

学习目标：

在加拿大儿科人群中检查多项社会经济地位 (SES) 测量与客观测量的阻塞性睡眠呼吸暂停 (OSA) 之间的关联。

方法：

对从加拿大两家医院睡眠诊所前瞻性招募的 188 名儿童（4-17 岁，平均年龄 9.3±3.5）进行横断面研究，使用 SES 的五项指标（包括父母教育、收入、社会阶层）的多变量调整线性和逻辑回归、地理位置和基于 MacArthur 主观社会地位量表的感知 SES 与四个多导睡眠图 OSA 变量相关，包括呼吸暂停低通气指数 (AHI)、呼吸暂停指数 (AI)、平均氧饱和度和氧饱和度指数。

结果：

总体而言，低家庭水平的 SES 似乎与儿童 OSA 的频率 (AI≥1) 和严重程度 (AHI≥5) 相关，母亲教育显示出最一致和显着的关联。具体来说，与受过大学教育的参与者相比，在控制包括 BMI 在内的因素后，母亲报告称其受教育程度低于高中的儿童患 OSA 的几率几乎是其三倍（优势比 [OR] 2.96 [95% CI: 1.05, 8.37]）。非城市儿童中 OSA 的频率和严重程度较低的地理位置也观察到了一致的关联。感知的 SES 与我们的结果呈最低程度的负相关。

结论：

这项横断面、多中心研究表明，SES 因素与儿童 OSA 的发生和严重程度有关。结果表明，需要将 SES 筛查纳入儿科 OSA 的诊断过程，以提供更有针对性的干预和以患者为中心的护理。