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

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.