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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
A controlled study of sleep related disordered breathing in obese children
1Department of Psychiatry, Prince of Wales and Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China. ykwing@cuhk.edu.hk
Insights
Obese children face a higher risk of obstructive sleep-related disordered breathing (SDB). Enlarged tonsils and higher BMI significantly increase this risk, necessitating prompt management.
Area of Science:
- Pediatric Sleep Medicine
- Obesity Research
- Otolaryngology
Background:
- The link between obesity and sleep-related disordered breathing (SDB) in children remains unclear, unlike in adults.
- Childhood obesity is a growing concern, potentially impacting respiratory health during sleep.
Purpose of the Study:
- To determine if obese children have a greater risk of obstructive SDB compared to normal-weight children.
- To investigate if pharyngeal lymphoid tissue enlargement exacerbates the risk of SDB in obese children.
Main Methods:
- A comparative study involving 46 obese and 44 normal-weight children, matched for age and sex.
- Participants underwent physical examinations, including upper airway assessment, and polysomnography (sleep studies).
Main Results:
- Obese children exhibited a higher prevalence and severity of SDB, predominantly obstructive in nature.
- SDB in obese children was associated with tonsil size (OR 12.67) and Body Mass Index (BMI) (OR 1.20).
- Prevalence of SDB in obese children ranged from 26% to 32.6%, versus 2.3%-4.5% in controls.
Conclusions:
- Obese children are at an elevated risk for developing obstructive SDB.
- Aggressive management of pharyngeal lymphoid tissue enlargement is recommended for obese children at risk of SDB.
Background:
Unlike the adult sleep related disordered breathing (SDB) patients who are typically obese, the relation between obesity and childhood SDB is not clear.
Aims:
To investigate whether obese children are more at risk of obstructive SDB when compared to normal population, and whether this risk is potentiated by the presence of pharyngeal lymphoid tissue.
Methods:
Forty six obese children (age 10.8 (SD 2.3) years; BMI 27.4 (SD 5.1)), and 44 sex and age matched normal weight children (age 11.7 (SD 2.1) years; BMI 18 (SD 1.8)) were studied. All children underwent a set of physical examinations (including the upper airways) and sleep studies.
Results:
The obese children were different from the normal weight children in terms of type (predominantly obstructive), frequency, and severity of respiratory disturbances. Depending on the criteria used, 26% or 32.6% of obese children had SDB; 2.3% of normal controls had OAI > or =1 and 4.5% had RDI > or =5. Presence of SDB was related to presence of tonsils (size >2; range 0-4) (OR 12.67, 95% CI 2.14 to 75.17) and BMI (OR 1.20, 95% CI 1.08 to 1.33).
Conclusions:
Results suggest that obese children are at increased risk of obstructive SDB; the presence of any pharyngeal lymphoid tissue enlargement in obese children should therefore be aggressively managed.
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