Helicobacter pylori seroprevalence in children with sleep-disordered breathing.

OBJECTIVE: Chronic Helicobacter pylori (HP) infection is considered to be a factor involved in obstructive sleep apnea syndrome (OSAS). This cross-sectional study examined the seroprevalence of HP in children with sleep-disordered breathing (SDB) in respect to OSAS severity and in reference to other common pediatric medical conditions. METHODS: Overnight polysomnography with pH-metry (PSG) was performed at a Sleep Laboratory (in the years 2008-2011). OSAS severity was determined based on Obstructive Apnea Index (OAI). Subjects were classified into primary snoring group (OAI < 1/hours), mild - moderate OSAS (OAI: 1-5/hour), and severe OSAS (OAI: ≥5/hour). HP IgG was tested by an enzyme-linked immunosorbent assay in the SDB (n = 115) and reference (n = 387) groups [reference group consisted of 4 subgroups based on ICD-10 diagnoses encompassing conditions affecting the skin, respiratory system, food hypersensitivity, and gastrointestinal tract]. Analyses were performed by nonparametric statistical tests. RESULTS: HP seropositivity was 10.4% (12/115) in the SDB group and 11.6% (45/387) in the reference group. HP positive and negative subjects did not differ in PSG, acid gastro-esophageal reflux index nor in age, sex, nutritional status (BMI-z score), and hematological indices in the SDB group. Seropositivity was found in 16.7% of the primary snoring group, 10.2% of mild-moderate OSAS, and in 11.1% of severe OSAS (chi(2) p = 0.832). CONCLUSIONS: Children with SDB are not more predisposed to a chronic HP infection than children with other common chronic pediatric conditions. HP seropositivity does not influence OSAS severity but possible infection should none-the-less be considered on a case-by-case basis.

Sleep-wake schedules in preschool children who snore.

PURPOSE: The aim of the study was to compare sleep-wake schedules between snoring and nonsnoring preschool age children. MATERIAL AND METHODS: Daytime and nighttime sleep duration, daytime and nighttime symptoms were assessed in 34 children at preschool age who snore (5.38+/-1.21 years) and in 66 age- and sex-matched nonsnorers (5.67+/-1.12 years). The snoring group consisted of children with obstructive sleep apnea (OSA) scores <+3.5 and >-1, the nonsnoring group with OSA score <-1. RESULTS: Children who snore differ from the nonsnorers in daytime sleep duration (51.62+/-28.9 minutes vs. 10.70+/-20.2 minutes; p<0.001), but not in nighttime sleep (10.97+/-0.52 hours vs. 9.83+/-1.34 hours; p>0.05). The percentage of children with daytime napping was higher in the snoring group than in the nonsnorers (47.1% vs. 9.1%; p<0.00004), and parents-reported behavioral problems were more frequent in children who snore (41.2% vs. 19.7%; p<0.02). Multivariate odds ratios, including variables for nighttime (sleep apnea) and daytime symptoms (daytime napping and oral breathing), showed that regular sleep during the day was the most predictive of snoring (OR=6.1; 95%CI 1.76-21.04; p<0.005). CONCLUSION: In preschool age children, when the daytime nap begins to disappear, snoring may have an effect on daytime schedule through an increased need for daytime sleep.