Multi-Level Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample

Seyni Gueye-Ndiaye; Marissa Hauptman; Xinting Yu; Le Li; Michael Rueschman; Cecilia Castro-Diehl; Tamar Sofer; Judith Owens; Diane R. Gold; Gary Adamkiewicz; Nervana Metwali; Peter S. Thorne; Wanda Phipatanakul; Susan Redline

doi:10.1016/j.chpulm.2023.100019

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Multi-Level Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample

Journal article

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Multi-Level Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample

Seyni Gueye-Ndiaye, Marissa Hauptman, Xinting Yu, Le Li, Michael Rueschman, Cecilia Castro-Diehl, Tamar Sofer, Judith Owens, Diane R. Gold, Gary Adamkiewicz, …

CHEST Pulmonary, Vol.1(3), 100019

12/2023

DOI: 10.1016/j.chpulm.2023.100019

PMCID: PMC10786403

PMID: 38222082

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Abstract

Pediatric sleep-disordered breathing (SDB) disproportionately affects children with low socioeconomic status (SES). The multi-level risk factors that drive these associations are not well understood. What are the associations between SDB risk factors, including individual health conditions (obesity, asthma, allergies), household SES (maternal education), indoor exposures (environmental tobacco smoke [ETS], pests), and neighborhood characteristics (neighborhood disadvantage [ND]), with pediatric SDB symptoms? Cross-sectional analyses were performed on 303 children, 6-12 years, enrolled in the Environmental Assessment of Sleep Youth study from 2018-2022. Exposures were determined by caregiver reports, assays of measured settled dust from the child’s bedroom, and neighborhood-level census data (deriving the Childhood Opportunity Index to characterize ND). The primary outcome was the SDB-related symptom burden assessed by the OSA-18 questionnaire total score. Using linear regression models, we calculated associations between exposures and SDB-related symptom burden, adjusting for socio-demographic factors, then health conditions, indoor environment, and neighborhood factors. The sample included 303 children (39%- Hispanic, Latino, Latina, or Spanish origin, 30%-Black or African American, 22% White, 11% Other). Increasing OSA-18 total scores were associated with low household SES after adjustment for demographic factors, and with asthma, allergies, ETS, pests (mouse, cockroach, and rodents), and an indoor environmental index (sum of the presence of pests and ETS; 0-2) after adjusting for socio-demographic factors. Even after further adjusting for asthma, allergies, and ND, ETS and pest exposure were associated (β; 95% CI) with OSA-18 (for ETS: 12.80; 7.07, 18.53, also adjusted for pest; pest exposure 3.69; 0.44, 6.94, also adjusted for ETS). In addition to associations with ETS, a novel association was observed for indoor pest exposure and SDB symptom burden. Strategies to reduce household exposure to ETS and indoor allergens should be tested as approaches for reducing sleep health disparities.

children

disparities

obstructive sleep apnea

OSA-18

Details

Title: Subtitle: Multi-Level Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample
Creators: Seyni Gueye-Ndiaye - Harvard Medical School
Marissa Hauptman - Harvard Medical School
Xinting Yu - Harvard Medical School
Le Li - Harvard Medical School
Michael Rueschman - Harvard Medical School
Cecilia Castro-Diehl - Harvard Medical School
Tamar Sofer - Department of Statistics, Harvard T.H. Chan School of Public Health
Judith Owens - Harvard Medical School
Diane R. Gold - Harvard Medical School
Gary Adamkiewicz - Department of Environmental Medicine, Harvard T.H. Chan School of Public Health
Nervana Metwali - Department of Occupational and Environmental Health, University of Iowa College of Public Health
Peter S. Thorne - Department of Occupational and Environmental Health, University of Iowa College of Public Health
Wanda Phipatanakul - Harvard Medical School
Susan Redline - Harvard Medical School
Resource Type: Journal article
Publication Details: CHEST Pulmonary, Vol.1(3), 100019
DOI: 10.1016/j.chpulm.2023.100019
PMID: 38222082
PMCID: PMC10786403
NLM abbreviation: CHEST Pulm
ISSN: 2949-7892
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100001465, name: American Thoracic Society; DOI: 10.13039/100000002, name: National Institutes of Health, award: L40HL165622, R01HL137192, R35HL135818, T32 HL007901; DOI: 10.13039/100000060, name: National Institute of Allergy and Infectious Diseases, award: K24AI106822; DOI: 10.13039/100000066, name: National Institute of Environmental Health Sciences, award: K23ES031663, P30ES000002, P30ES005605
Language: English
Electronic publication date: 09/2023
Date published: 12/2023
Academic Unit: Civil and Environmental Engineering; Occupational and Environmental Health
Record Identifier: 9984464475502771

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