• Emmanouel I Alexopoulos, George Charitos, Georgia Malakasioti, Vasiliki Varlami, Konstantinos Gourgoulianis, Elias Zintzaras, and Athanasios G Kaditis.
• Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece.
• J. Pediatr. 2014 Jun 1; 164 (6): 1352-7.

ObjectiveTo test the hypothesis that history of adenoidectomy and/or tonsillectomy (AT) in at least 1 of the parents during childhood, is a risk factor for moderate-to-severe obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI] >5 episodes/hour) in the offspring with snoring.Study DesignData of children with snoring who were referred for polysomnography over 12 years by primary care physicians were reviewed.ResultsData of 798 children without history of prior AT, neuromuscular, or genetic disorders or craniofacial abnormalities were analyzed. Of these children, 69.3% had tonsillar hypertrophy, 25.8% were obese, 26.8% had at least 1 parent with history of AT, and 22.1% had AHI >5 episodes/hour. Parental history of AT was significantly associated with moderate-to-severe OSA (logit model including sex, tonsillar hypertrophy, obesity, and physician-diagnosed wheezing; OR [95% CI], 1.70 [1.18-2.46]; P < .01). When significant variables from the logit model (tonsillar hypertrophy, obesity, parental history of AT) were considered independently or in combination, tonsillar hypertrophy combined with history of AT in at least 1 of the parents had high specificity (84.4%) and the highest positive likelihood ratio (1.78) for identifying children with AHI >5 episodes/hour.ConclusionsAmong children with snoring who are referred for polysomnography by primary care physicians, those with tonsillar hypertrophy and parental history of AT have increased risk of moderate-to-severe OSA and represent 1 of the subgroups that should be prioritized for a sleep study in settings with limited resources.Copyright © 2014 Elsevier Inc. All rights reserved.

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