0868 Determinants of the Developmental Trajectories of Sleep Disordered Breathing from Childhood Through Young Adulthood

Abstract Introduction Given the lack of lifespan epidemiological studies describing the developmental trajectories of sleep disordered breathing (SDB) in children as they grow into adults, little is known regarding their lifespan risk factors. Methods A total of 698 participants from the Penn State Child Cohort, a randomly-selected population-based sample (52% female, 24% racial/ethnic minority), underwent in-lab polysomnography in childhood (5-12y), adolescence (12-19y), and young adulthood (20-32y) with a median follow-up time of 15y. Growth mixture models were used to classify the 698 individual trajectories of apnea/hypopnea index (AHI) into latent age-related classes (trajectories), while including sex, race/ethnicity, body mass index, and treatment (adenotonsillectomy [AT] or positive airway pressure [PAP] therapy) as risk factors. Results AHI showed four developmental trajectories. Female sex (p=0.001), racial/ethnic minority (p=.0001) and, to a lesser extent, overweight (p=.07) and obesity (p=.06), predicted a trajectory with stable AHI from age 5 through 30 (85.8% of subjects). Female sex (p=.08) predicted a trajectory with AHI that increased at age 13, peaked at age 16, and decreased after age 20 (3.4%). Obesity (p<.0001) predicted a trajectory with higher AHI at ages 5-10 that remained elevated through age 30 (7.5% of subjects). Male sex (p=.004) and overweight (p<.0001) predicted a trajectory with AHI that increased at age 16 and continued to further increase through age 30 (3.3% of subjects). Neither AT nor PAP significantly predicted any of the trajectories. Conclusion Obesity is a key determinant of childhood-onset SDB and male sex and overweight of adolescent-onset SDB worsening through young adulthood. Female sex is associated with more favorable developmental trajectories, particularly that improving in the transition from adolescence to young adulthood. Support (if any) R01HL136587, UL1TR002014