Prevalence of OSA Risk and Bruxism in Children With Autism Spectrum Disorders

Children with autism spectrum disorder (ASD) often present with sleep disorders, including obstructive sleep apnea (OSA), a condition characterized by upper airway obstruction during sleep. Bruxism has been recently described as being associated with OSA. This study aimed to assess the prevalence of OSA risk and bruxism in pediatric ASD patients compared to age and sex-matched healthy controls using the validated screening tool Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (SRBD-PSQ). Fifty-eight consecutive pediatric ASD patients were screened for OSA and bruxism at the Dentistry Unit of A. Gemelli Policlinic and compared to 58 healthy patients using chi-square tests. Comparison between the two groups was repeated by controlling for body mass index (BMI) and behavioral symptoms with ANCOVA and logistic regression analyses. Of 58 ASD patients (10.3 ± 3.3 y/o, 74.5% males), 60.3% presented with an increased OSA risk, compared to 13.8% in the controls (p < 0.001, OR = 3.682, 95% CI: 1.933, 7.012). After controlling for BMI (which was significantly higher among ASD patients), those with ASD had significantly higher odds of OSA risk compared to controls (OR = 9.6, 95% CI: 3.56, 26.21). After controlling for the SRBD-PSQ behavioral component, the association between ASD and OSA risk lost its significant difference (p < 0.862). No significant difference was found between ASD patients and controls in awake (3.6% vs. 6.9%, p = 0.680) and sleep (25.5% vs. 32.8%, p = 0.393) bruxism. Pediatric patients with ASD present at higher risk of OSA, most likely explained by the behavioral symptoms; self-reported bruxism did not significantly differ compared to healthy controls.