Body weight status and obstructive sleep apnea in children

Abstract

OBJECTIVE:The relationship between weight status, adenotonsillar hypertrophy and obstructive sleep apnea (OSA) in children has not yet been well studied. As the sleep parameters may show a disparity in different weight statuses, this study examined the relationship between the data of over-night polysomnography and different weight statuses, as well as the impact of adenotonsillar hypertrophy on children with OSA. METHODS: Children with sleep disturbances were recruited from our clinics. Standard physical examinations, history taking, lateral neck roentgenography, and full-night polysomnography were obtained. Children were divided into four groups based on the age-and gender-corrected body mass index (BMI): underweight, normal weight, overweight and obese. An adenoidal/ nasopharyngeal ratio of more than 0.67 was considered adenoidal hypertrophy. Tonsillar hypertrophy was defined as having Grade III tonsils or above. RESULTS: From July 2006 to January 2009, 197 children were included in this study. Obese children had a significantly higher apnea --hypopnea index (AHI), obstructive apnea index and lower minimum oxygen saturation (MinSaO 2 ) than those of the other groups. Underweight children had the second highest AHI. A negative correlation was also found between BMI z scores and MinSaO 2 (r ¼ À0.194; P ¼ 0.007). Children with tonsillar hypertrophy (P ¼ 0.001) were associated with a higher risk of having OSA. The risk of having OSA was significantly higher in obese children (P ¼ 0.001) and underweight children (P ¼ 0.043) than in those with a normal weight. CONCLUSION: Obesity, underweight status and tonsillar hypertrophy are associated with children having OSA, and obese children have a significantly higher risk than children with underweight status.

Body Fat Composition: A Predictive Factor for Sleep Related Breathing Disorder in Obese Children

“…1,20 In a study of 197 children age 2-18 years, Kang et al found significantly increased OAHI in obese as well as underweight subjects compared to a normal weight group. 22 Combined with our findings, these studies highlight that factors other than obesity such as puberty, genetics, respiratory control, and upper airway anatomy significantly contribute to the presence and severity of OSA in this population. For instance, Bruno et al found a significant relationship between fat mass percentage in the neck region (measured by DEXA) and severity of OSA but no correlation between percent of abdominal fat mass and OSA.…”

Discrepancy between Objective and Subjective Outcomes after Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome

“…4 Obstructive sleep apnea in children is mainly due to enlarged tonsils and adenoids that obstruct the upper airway. 1 Removing tonsils and adenoids (adenotonsillectomy [T&A]) is, therefore, the first-line therapy for pediatric OSA worldwide.…”

Treatment outcomes of supraglottoplasty for pediatric obstructive sleep apnea: A meta-analysis

“…OSA in children includes a spectrum of respiratory disorders characterized by upper airway collapse during sleep [23]. Untreated OSA in children is associated with adverse cardiovascular [24], neurocognitive [25], and somatic growth consequences [26]. The pathophysiology of childhood OSA is mainly caused by enlarged adenotonsillar tissues [27,28]; therefore, adenotonsillectomy is the first-line therapy for pediatric OSA worldwide [29e34].…”