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Does neck circumference predict obstructive sleep apnea in children with obesity?

Sherri L Katz1, Henrietta Blinder2, Tanvi Naik3

  • 1Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 5B2, Canada.

Sleep Medicine
|January 8, 2021
PubMed

Insights

Neck-to-height ratio (NHR) and male sex predict obstructive sleep apnea (OSA) severity in children with obesity. Children with obesity and NHR above identified thresholds may benefit from earlier polysomnography for OSA screening.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Obesity Research

Background:

  • Obstructive sleep apnea (OSA) affects a significant portion of children with obesity, posing diagnostic challenges.
  • Long wait times for polysomnography (PSG) complicate timely OSA identification in this population.
  • Neck circumference (NC) and neck-to-height ratio (NHR) have shown potential as OSA predictors.

Purpose of the Study:

  • To evaluate the association between NC, NHR, and OSA in children with obesity.
  • To develop a predictive model for OSA using NHR, adjusting for age, sex, and Tanner stage.
  • To identify NHR thresholds indicative of OSA in pediatric populations with obesity.

Main Methods:

  • Study included children aged 8-17 years with obesity (BMI >95th percentile) undergoing PSG.
  • Associations between NC, NHR, and OSA were analyzed.
  • A negative binomial regression model predicted the obstructive apnea hypopnea index (OAHI) using NHR, age, sex, and Tanner stage.

Main Results:

  • 71 children participated; 25.4% had severe OSA.
  • Each 0.01 increase in NHR correlated with a 55% increase in OAHI.
  • Male sex was associated with a 119% higher OAHI compared to females.
  • Threshold NHR for moderate-severe OSA was 0.25 in females and 0.23 in males.

Conclusions:

  • NHR and male sex are independent predictors of OSA severity in children with obesity.
  • Children with obesity and NHR above identified thresholds have a higher likelihood of moderate-severe OSA.
  • These findings suggest NHR may aid in prioritizing children for earlier OSA testing.
Abstract

Keywords:
AnthropometricsBody fat distributionChildrenNeck circumferenceObesityObstructive sleep apnea

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