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Associations between adenotonsillar hypertrophy, age, and obesity in children with obstructive sleep apnea

Kun-Tai Kang1, Chen-Han Chou, Wen-Chin Weng

  • 1Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, R.O.C. ; Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan, R.O.C. ; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan, R.O.C.

Plos One
|November 9, 2013
PubMed

Insights

Adenotonsillar hypertrophy and obesity significantly increase the risk of childhood obstructive sleep apnea (OSA). While adenoid size is a factor in younger children, its influence diminishes in adolescence.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Pulmonology

Background:

  • Childhood obstructive sleep apnea (OSA) is a prevalent condition.
  • Adenotonsillar hypertrophy is a known risk factor for pediatric OSA.
  • The interplay of age and obesity with adenoid and tonsil size in OSA requires further investigation.

Purpose of the Study:

  • To determine the contribution of adenoid and tonsil size to childhood OSA.
  • To examine the interaction between adenotonsillar hypertrophy, age, and obesity in pediatric OSA patients.

Main Methods:

  • A cohort of 495 symptomatic children aged 1-18 years was analyzed.
  • Adenoid size was measured via lateral radiographs, and tonsil size was graded by otolaryngologists.
  • Polysomnography was used to assess OSA severity (Apnea-Hypopnea Index), with comparisons made between obese and non-obese children across age groups.

Main Results:

  • Both tonsil grade and adenoid size positively correlated with the Apnea-Hypopnea Index (AHI) in the overall cohort.
  • Adenoid size's association with AHI was significant in toddlers, preschoolers, and school-aged children, but not in adolescents.
  • Obesity, tonsillar hypertrophy, and adenoidal hypertrophy were all independently associated with increased OSA risk.

Conclusions:

  • Adenotonsillar hypertrophy and obesity are primary drivers of OSA in children.
  • The impact of adenoid size on OSA severity lessens during adolescence.
Abstract

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