Snoring and obstructive sleep apnea in Thai school-age children: prevalence and predisposing factors

Pediatr Pulmonol. 2001 Sep;32(3):222-7. doi: 10.1002/ppul.1112.


We studied the prevalence of habitual snoring and its associations with tonsillar size, allergic rhinitis, obesity, and parental smoking, as well as prevalence of obstructive sleep apnea (OSAS) in a sample of 1,142 children aged 6-13 years (mean, 7.25 +/- 0.58) from seven randomly selected schools in Hat yai, Southern Thailand. Eighty-five (8.5%) of the children were habitual snorers; the prevalence was the same in boys and girls. Significant and independent association was present between snoring and allergic rhinitis with an odds ratio of 5.27 (95% CI, 1.57-17.77). The odds ratio was significantly increased to 2.65 (CI, 1.31-5.39), 5.72 (CI, 2.67-12.25), and 11.06 (CI, 1.91-63.84) in children with tonsillar size of 2+, 3+, and 4+, respectively. Of the 85 habitual snorers, 69 could be contacted by telephone call or by hospital visit. Eight of these were reported to have at least one of the following symptoms: difficulty breathing during sleep, stop breathing at night, restless sleeping and frequent awakening, sleeping with the head tipped back, and a tendency to breathe through the mouth rather than the nose. Polysomnographic studies in these 8 children demonstrated an apnea/hypopnea index of 0.6-4.7 per hr. Seven children met the criteria for OSAS. Thus, our estimate of the prevalence of OSAS among Thai schoolchildren was 7/1,008 (0.69%). We have shown that the prevalence of habitual snoring was 8.5%, and the prevalence of OSAS in a sample of Asian school-age children in Southern Thailand was 0.69%, which was similar to that observed in Western populations. An association of snoring with tonsillar size or allergic rhinitis was demonstrated. All but one of the snoring children with sleep-related symptoms had OSAS, but all were mild cases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoids / pathology
  • Adolescent
  • Child
  • Epidemiologic Studies
  • Female
  • Humans
  • Male
  • Obesity / complications
  • Prevalence
  • Rhinitis, Allergic, Perennial / complications
  • Risk Factors
  • Sleep Apnea, Obstructive / epidemiology*
  • Sleep Apnea, Obstructive / etiology
  • Snoring / epidemiology*
  • Thailand / epidemiology
  • Tobacco Smoke Pollution / adverse effects


  • Tobacco Smoke Pollution