Right bundle-branch block and precordial injury pattern in V1 through V3 is common in SUDS patients and represents an arrhythmogenic marker that identifies patients who face an inordinate risk of ventricular fibrillation or sudden death.

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.

In 1999, a survey was carried out in 1,008 Thai children aged 7 years, which found that 85 (8.5%) children were habitual snorers, and 7 (0.69%) children had mild obstructive sleep apnea syndrome (OSAS). Since the natural history of snoring and untreated mild OSAS is still largely unknown, this study was undertaken in 2002 in the same group of children to determine the natural history of snoring and OSAS. Questionnaires, consisting of questions about snoring, were sent to the parents of the 1,008 children. Polysomnography was performed in 1) the 7 children who had OSAS in the previous survey, and 2) other habitual snorers who had sleep-related symptoms in this survey. Seventy-five percent of the questionnaires were returned. The prevalence of habitual snoring had decreased slightly, from 8.5% in 1999 to 6.9% in 2002. Sixty-five percent of the children who had snored habitually in the previous survey no longer did so, whereas 4.5% of the children who previously never snored or snored sometimes had become habitual snorers. Of the 7 children who had OSAS previously, 5 had persistent snoring, and polysomnographic studies revealed more severe OSAS, with an apnea-hypopnea index (AHI) of 1.5-9.2 per hour of sleep. Five children were newly diagnosed with OSAS in this survey, with an AHI of 1.5-7.5. The overall prevalence of OSAS in this survey was 10/755 (1.3%). In conclusion, 65% of children who snored habitually no longer did so when they got older, while 9% of children had developed OSAS. We suggest that regular follow-up in children with habitual snoring may be needed, and additional research is required to determine the indications for polysomnography and neurobehavioral and cardiovascular assessment. We also showed that children with mild OSAS could develop more severe disease if left untreated, suggesting that deferment of treatment may have negative consequences.

No abstract

Background  Sleep in a supine position and in a bed separate from but proximate to adults is recommended, in several Western countries, to prevent Sudden Infant Death Syndrome (SIDS). Cultural differences and a lower rate of SIDS in Asian populations may affect concern with this problem and thus infant sleeping arrangements. Objective  To study bed sharing and sleep position in Thai neonates and the relationship to infant and maternal characteristics. Methods  A cross‐sectional survey based on interviews with parents of infants aged 21 days old, was conducted under the Prospective Cohort Study of Thai Children. Results  Of the total sample, 2236/3692 (60.6%) infants shared a bed with their parents. Sixty per cent of the parents placed their infants to sleep in a supine position, 32.2% on their side and 4.9% in a prone position. Bed sharing was associated with older maternal age, higher education, Muslim mother, and with work status of professional career or unemployed. Placing the infants to sleep in a prone position was associated with infant birth weight of greater than 2500 g, older maternal age, higher education, Buddhist mother, mother with professional career and middle‐class household economic status. Conclusions  Infant bed sharing is a common practice in the Thai culture, as in other Asian countries. The prone sleep position is less common than in Western populations. The main factor associated with both bed sharing and putting infants to sleep in the prone position was a higher maternal socioeconomic status (SES), in contrast to previous studies in some Western countries in which both practices were associated with low maternal SES. Cultural differences may play an important role in these different findings.