The association between secondhand smoke and sleep-disordered breathing in children: A systematic review

Sebastian M. Jara, James R. Benke, Sandra Y. Lin, Stacey L. Ishman

Research output: Contribution to journalArticle

Abstract

Objective: To systematically review existing literature on the association between secondhand smoke and sleepdisordered breathing in children.

Data Sources: PubMed, Embase, Cochrane CENTRAL, Web of Science, and Scopus.

Review Methods: Inclusion criteria included English-language papers containing original human data, with seven or more subjects and age <18 years. Data were systematically collected on study design, patient demographics, clinical characteristics/outcomes, and level of evidence. Two investigators independently reviewed all manuscripts.

Results: The initial search yielded 72 abstracts; 18 articles were ultimately included with a total study population of 47,462 patients. Fifteen (83%) articles found a statistically significant association between secondhand smoke and sleepdisordered breathing. All were case-control studies. Quality of articles based on the Newcastle-Ottawa scale averaged 5.8/9 stars. Secondhand smoke was characterized by serum cotinine testing in only two (11%) studies. Sleep-disordered breathing was quantified by polysomnography in only four (22%) of the studies and only one (6%) classified subject using polysomnography exclusively. Habitual snoring was the most common form of sleep-disordered breathing studied in 14/18 (78%) studies, whereas obstructive sleep apnea was reported in one (6%) study and sleep-related hypoxia in another (6%) study.

Conclusions: Although the majority of studies included in this review found a significant association between secondhand smoke and sleep-disordered breathing, all of them were evidence level 3b, for an overall grade of B (Oxford Centre for Evidence-based Medicine). Further higher-quality studies should be performed in the future to better evaluate the relationship between second- smoke and sleep-disordered breathing in children.

Original languageEnglish (US)
Pages (from-to)241-247
Number of pages7
JournalLaryngoscope
Volume125
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • Obstructive sleep apnea
  • Pediatric
  • Secondhand smoke
  • Sleep-disordered breathing
  • Snoring
  • Systematic review

ASJC Scopus subject areas

  • Otorhinolaryngology

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