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Updated: May 15, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Association Between Severe Obesity and Pediatric Obstructive Apnea-A Retrospective Case Series
Tyler A Durham1, Basir S Mansoor1, Stephen R Chorney1,2
1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Objective:
To investigate the impact of severe obesity on the severity of pediatric obstructive sleep apnea (OSA).
Study Design:
Retrospective case series.
Setting:
Tertiary stand-alone pediatric hospital.
Methods:
Consecutive children with obesity (≥95th percentile body mass index [BMI]) who underwent full-night polysomnography between January 2021 and December 2021 were analyzed. Patients were categorized into obesity (≥95th percentile BMI and <120% of the 95th percentile) and severe obesity (≥120% of the 95th percentile BMI). The association between severe obesity and severe OSA was assessed using multiple logistic regression.
Results:
The study included 282 patients with a median age of 9.2 years (interquartile range 5.9-12.3), 63% male, and 65% Hispanic. In total, 53% were severely obese. Severely obese children had a higher prevalence of severe OSA (53% vs 33%, P < .001) and very severe OSA (apnea-hypopnea index ≥ 24; 24% vs 11%, P = .006). Multiple logistic regression revealed that severe obesity was associated with severe OSA (adjusted odds ratio [aOR] = 3.44; 95% confidence interval [CI], 1.82-6.53; P < .001) after adjusting for age, sex, and tonsillar hypertrophy. Among 170 patients who underwent posttonsillectomy polysomnography, 29% exhibited residual OSA, with 19% having residual severe OSA. Class 3 severe obesity was associated with residual OSA (aOR = 4.05, 95% CI = 1.09-15.00).
Conclusion:
Children with severe obesity face substantial sleep disturbances and a heightened risk of residual OSA following adenotonsillectomy.
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