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Lifelong high or increasing body mass index (BMI) from childhood to middle age significantly elevates the risk of developing obstructive sleep apnoea (OSA). However, weight loss in obese children does not increase their risk of adult OSA.

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Area of Science:

  • Epidemiology
  • Sleep Medicine
  • Public Health

Background:

  • Short-term weight fluctuations are known to affect obstructive sleep apnoea (OSA).
  • The long-term impact of body mass index (BMI) changes throughout life on adult OSA risk remains under-researched.
  • Understanding life-course BMI trajectories is crucial for predicting and preventing OSA.

Purpose of the Study:

  • To investigate the association between body mass index (BMI) trajectories from childhood to middle age and the risk of obstructive sleep apnoea (OSA) approximately 10 years later.
  • To identify specific BMI patterns over the life course that may predispose individuals to developing OSA in adulthood.

Main Methods:

  • Utilized data from the Tasmanian Longitudinal Health Study (TAHS), a population-based cohort.
  • Analyzed eight time-point BMI measurements from age 5 to 43 years to define five distinct BMI trajectories.
  • Assessed probable OSA at age 53 years using the STOP-Bang questionnaire, corroborated by Berlin and OSA-50 questionnaires.
  • Defined clinically significant diagnosed OSA based on medical diagnosis or sleep study results.
  • Employed multivariable logistic regression to examine the associations between BMI trajectories and OSA risk.

Main Results:

  • Individuals with persistently high BMI trajectories or those with an average-increasing BMI from childhood showed a significantly elevated risk of probable OSA (aOR = 3.73 and 5.28, respectively).
  • These findings were consistent when considering clinically diagnosed OSA.
  • A low BMI trajectory was associated with a reduced likelihood of OSA compared to the average trajectory.
  • Notably, a trajectory characterized by high BMI in childhood followed by weight decrease was not linked to an increased risk of OSA.

Conclusions:

  • Middle-aged adults with consistently high or increasing BMI from childhood face a heightened risk of obstructive sleep apnoea (OSA).
  • Physicians and the public should be aware of these long-term BMI-OSA associations.
  • A significant finding is that obese children who achieve weight loss do not exhibit a higher risk of developing OSA in middle age.