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Sleep architecture and obstructive sleep apnea in obese children with and without metabolic syndrome: a case control
Shabnam Jalilolghadr1, Zohreh Yazdi2, Manoochehr Mahram1
1Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Insights
Obese children with metabolic syndrome experience worse sleep quality, including more awakenings and altered sleep stages. Severe obstructive sleep apnea (OSA) is independently linked to metabolic syndrome in these children.
Area of Science:
- Pediatric Endocrinology
- Sleep Medicine
- Metabolic Disorders
Background:
- Obesity and metabolic disorders are linked to obstructive sleep apnea (OSA).
- Understanding the relationship between metabolic syndrome and sleep in obese children is crucial.
Purpose of the Study:
- To compare sleep architecture and OSA prevalence in obese children with and without metabolic syndrome.
- To investigate the association between metabolic syndrome and sleep disturbances in pediatric obesity.
Main Methods:
- Case-control study involving 42 obese children with metabolic syndrome and 38 matched controls.
- Utilized questionnaires (BEARS, Children's Sleep Habits Questionnaire) and polysomnography (PSG).
- Statistical analysis included chi-square, T test, Mann-Whitney U, and logistic regression.
Main Results:
- Children with metabolic syndrome showed longer non-rapid eye movement (NREM) sleep and N1 stage, and shorter REM sleep.
- Increased waking after sleep onset (WASO) was observed in the metabolic syndrome group.
- Severe OSA was more frequent in controls, but severe OSA and shorter REM sleep were independently associated with metabolic syndrome.
Conclusions:
- Obese children with metabolic syndrome exhibit disrupted sleep architecture, including increased WASO and N1 sleep, potentially due to OSA severity.
- Severe OSA and altered REM sleep are independently associated with metabolic syndrome in obese children.
- Further longitudinal research is required to confirm the link between metabolic syndrome and OSA in this population.
Purpose:
Obesity and biochemical parameters of metabolic disorders are both closely related to obstructive sleep apnea (OSA). The aim of this study was to compare sleep architecture and OSA in obese children with and without metabolic syndrome.
Methods:
Forty-two children with metabolic syndrome were selected as case group and 38 children without metabolic syndrome were matched for age, sex, and BMI as control group. The standardized Persian version of bedtime problems, excessive daytime sleepiness, awakenings during the night, regularity and duration of sleep, snoring (BEARS) and Children's Sleep Habits Questionnaires were completed, and polysomnography (PSG) was performed for all study subjects. Scoring was performed using the manual of American Academy of Sleep Medicine for children. Data were analyzed using chi-square test, T test, Mann-Whitney U test, and logistic regression analysis.
Results:
Non-rapid eye movement (NREM) sleep and N1 stage in the case group were significantly longer than the control group, while REM sleep was significantly shorter. Waking after sleep onset (WASO) was significantly different between two groups. Severe OSA was more frequent in the control group. Multivariate logistic regression analysis showed that severe OSA (OR 21.478, 95 % CI 2.160-213.600; P = 0.009) and REM sleep (OR 0.856, 95 % CI 0.737-0.994; P = 0.041) had independent association with metabolic syndrome.
Conclusions:
Obese children with metabolic syndrome had increased WASO, N1 sleep stage, and severe OSA. But the results regarding sleep architecture are most likely a direct result of OSA severity. More longitudinal studies are needed to confirm the association of metabolic syndrome and OSA.
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