Fatigue and Quality of Life in Children with Hearing Loss or Obstructive Sleep Apnea.

OBJECTIVE: To investigate the fatigue levels of children with hearing loss (HL) and obstructive sleep apnea (OSA), hypothesizing that the fatigue experienced by children with HL is under-recognized. STUDY DESIGN: Cross-sectional survey. METHODS: We identified children aged 2-18 with HL, OSA, sleep-disordered breathing (SDB), and controls from a pediatric otolaryngology clinic and sleep center. Children and/or parents completed the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS), Hearing Environments And Reflection on Quality of Life (HEAR-QL), and OSA-18. RESULTS: Responses of 50 children with HL, 79 with OSA, and 18 with SDB were compared with those of 49 recruited controls (RC) and literature controls (LC). Children with HL or OSA had higher fatigue than controls in the PedsQL MFS self-reported (HL 65.4, OSA 54.7, RC 71.8, LC 80.5, p < 0.001) and parent-reported (HL 64.6, OSA 59.3, RC 75.2, LC 89.6, p < 0.001). Children with HL had Cognitive Fatigue similar to that of children with OSA (self 60.4 vs. 49.5, p = 0.170; parent 56.0 vs. 56.7, p = 0.998), though with decreased Sleep/Rest Fatigue (self 67.8 vs. 56.3, p = 0.033; parent 69.8 vs. 57.5, p = 0.001). Children with HL or OSA had lower disease-related quality of life (QOL) than controls in the HEAR-QL and OSA-18, respectively. Stratification with disease severity revealed no differences in fatigue. CONCLUSION: Children with HL or OSA experience higher fatigue and lower QOL than controls. Similar Cognitive Fatigue in both groups suggests under-recognized fatigue in children with HL. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:443-451, 2024.

Exploring the Association Between Pediatric Obstructive Sleep Apnea Severity and Quality of Life.

OBJECTIVES: To investigate the relationship between pediatric obstructive sleep apnea (OSA) severity and quality of life (QOL). STUDY DESIGN: This study was a cross-sectional survey. METHODS: Patients aged 2-18 years being evaluated for OSA were recruited from a pediatric otolaryngology clinic and sleep center. Participants completed the Obstructive Sleep Apnea Questionnaire (OSA-18) and the PedsQL™ Multidimensional Fatigue Score (MFS). RESULTS: Responses of 18 control participants without OSA, 26 participants with clinically resolved OSA, 19 with non-obstructive sleep disordered breathing (SDB), 29 with mild OSA, 21 with moderate OSA, and 27 with severe OSA were analyzed. OSA-18 scores for controls were lower (indicating higher QOL) than patients with SDB (mean difference [MD] = -31.1; 95% CI -42.7 to -19.5), mild OSA (MD = -30.4; 95% CI -40.1 to -20.7), moderate OSA (MD = -23.6; 95% CI -34.5 to -12.7), or severe OSA (MD = -40.1; 95% CI -50.0 to -30.2). Participants with resolved OSA also had lower OSA-18 scores than participants in the SDB and OSA groups. Few differences were observed between the SDB, mild OSA, moderate OSA, and severe OSA groups on either the OSA-18 or PedsQL MFS, and these did not demonstrate a clear pattern. Linear regression of apnea hypopnea index (AHI) and OSA-18 or PedsQL MFS scores revealed weak relationships (R2 < 0.1). CONCLUSION: Using both an OSA-specific measure and generic fatigue measure, no consistent differences in QOL scores were found between children with varying OSA severities. Therefore, disease burden in pediatric patients with mild OSA and SDB should not be underestimated. LEVEL OF EVIDENCE: Level 3 Laryngoscope, 2024.