A Pilot Study: Is Snoring During Pediatric Dental Procedures Indicative of Obstructive Sleep Apnea?

Study Objectives: To determine whether pediatric snoring during sedation could be used to screen for obstructive sleep apnea (OSA) by pediatric dentists. Methods: Pediatric dental patients requiring moderate sedation with American Society of Anesthesiologists (I or II) or Brodsky classification (grade 1 and 2) were identified, recruited, separated in groups of snorers and nonsnorers, and then matched based on body mass index to within ±5%. Parents completed a Pediatric Symptom Checklist (PSC), and Pediatric Sleep Questionnaire (PSQ). OSA was diagnosed using a home sleep monitoring device. Groups were compared using a t-test. Results: Overall, 19 children were screened for eligibility and 17 enrolled: 10 who snored (59%) and 7 control participants. Although children who snored during sedation had a nominally higher respiratory disturbance index (RDI) (mean = 5.3 vs. 4.3), this difference was not statistically significant (p > 0.7). Using a cutoff RDI > 5 to indicate significant OSA, 5 of 8 in the snorer group and 2 of 4 in the nonsnorer group met this criterion. Conversely, one nonsnoring participant had a maximum relative loudness of 27dB, which resulted in a nominally higher group mean than the snoring group. The questionnaire results of both the PSC and PSQ average was 5 points higher in the snoring group but the difference was not statistically significant (PSQ p = 0.056, PSC p > 0.4). Conclusions: Snoring alone during pediatric dental procedures does not appear to be indicative of obstructive sleep apnea. Recognition of pediatric sleep apnea may be enhanced through questionnaires and adding snore analysis to home-based sleep apnea screening.