Ho-ho-ho! Gather ’round, my little elves, for a tale from the frosty realm of medical research, where the bustling workshop of scientists has been studying the sneaky Grinch known as pediatric obstructive sleep apnea (OSA). Now, OSA is a bit like a stocking stuffed with coal; it blocks the airways when children are trying to snooze, leaving them as restless as reindeer on Christmas Eve.

In the bustling city of Boston, the clever elves in white coats have been peeking into the lives of 2,962 little cherubs from the Boston Birth Cohort, ranging from newborns to the ripe old age of five. They’ve been particularly interested in those tiny tots who’ve had a bout with the lower respiratory tract infections (LRTI) during their first two years. You see, these infections are like the icy patches on the roof that make it tricky for my sleigh to land.

The researchers divided these children into three lists, much like I do with my naughty and nice lists. There were 235 children who had been hospitalized with severe LRTI—these were the ones who faced the biggest blizzard. Another 394 had mild LRTI and were treated as outpatients, like receiving a small lump of coal. And then there were 2,333 children who were as healthy as a fresh batch of gingerbread cookies, serving as the reference group.

Using their magical tools—Kaplan-Meier survival estimates and Cox proportional hazards models, which are a bit like my list-checking twice—they found that the children with mild LRTI were more likely to develop OSA, with a hazard ratio (HR) of 1.44. But, jingle bells, the children with severe LRTI were at the highest risk, with an HR of 2.06, no matter if they were born during a snowstorm or a clear night, or whether their mothers were as plump as Mrs. Claus or as slender as a candy cane.

Other factors that made OSA more likely included being born prematurely, like a Christmas surprise, and having a mother with a figure like a jolly bowl full of jelly (that’s maternal obesity for you non-Santa folks).

Now, whether the LRTI was as mild as a light snowfall or as severe as a North Pole blizzard, the time it took for OSA to show up was about the same, with a median of 23 to 25.5 months. That’s like waiting almost two Christmases to find out if you’re getting a new bike or a new inhaler!

So, my dear friends, the moral of this story is that infants with severe early-life LRTI are more likely to get OSA, and we need to keep our eyes peeled, like watching for Rudolph’s red nose on a foggy night. Monitoring for OSA should continue through the preschool years, as it can be as sneaky as an elf slipping away with the last cookie.

And with that, I must return to my sleigh preparations. Remember, keep your chimneys clear and your airways clearer. Merry Christmas to all, and to all a good, snore-free night! 🎅🎄