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Published on: December 6, 2016
Prevalence and Polysomnographic Features of Obstructive Sleep Apnea in Childhood Obesity
Hanna Y Gedamu1, Seckin O Ulualp1,2, Anna Wani3
1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Insights
Obstructive sleep apnea (OSA) is highly prevalent in children, especially those with severe obesity. Increased obesity severity correlates with higher odds and severity of OSA, impacting oxygen saturation and CO2 levels.
Area of Science:
- Pediatric Sleep Medicine
- Obesity Research
- Otolaryngology
Background:
- Obstructive sleep apnea (OSA) is a common condition in children.
- Obesity is a known risk factor for OSA, but its impact across different BMI categories requires further elucidation.
- Understanding OSA prevalence and polysomnography (PSG) features in pediatric obesity subcategories is crucial for diagnosis and management.
Purpose of the Study:
- To determine the prevalence of OSA in children across various BMI categories.
- To identify specific polysomnography (PSG) features associated with OSA in children with different levels of obesity.
- To investigate the relationship between obesity severity and OSA prevalence and severity.
Main Methods:
- Retrospective analysis of 604 children evaluated for obstructive sleep-disordered breathing.
- Exclusion of children with prior tonsillectomy/adenoidectomy.
- Data collection included demographics, comorbidities, PSG parameters, and BMI categories (underweight to Class III Obesity). Statistical analyses included chi-squared tests, logistic regression, MANOVA, and linear regression.
Main Results:
- A high prevalence of OSA (81%) was observed in the study cohort.
- OSA prevalence significantly differed across BMI categories (p < 0.001), with the highest odds in Class III Obesity (OR=5.01).
- Children with Class II and III Obesity had significantly higher odds of severe OSA (AHI > 10) and demonstrated significant differences in PSG parameters like minimum SpO2 and mean CO2 compared to healthy-weight children without OSA.
Conclusions:
- The prevalence and severity of OSA in children are strongly associated with obesity.
- Higher obesity severity correlates with increased odds of OSA and more severe OSA.
- Obesity significantly impacts key polysomnography metrics, including SpO2 and CO2 levels, highlighting the need for tailored diagnostic and management strategies.
Objectives:
To identify the prevalence and polysomnography (PSG) features of obstructive sleep apnea (OSA) in subcategories of children with obesity.
Methods:
Children with obstructive sleep-disordered breathing evaluated in pediatric otolaryngology clinic and referred for PSG between January 2023 and December 2023 were included. Children with a history of tonsillectomy and/or adenoidectomy were excluded. Collected data included demographics, comorbidities, PSG parameters, and BMI categories including underweight, healthy weight, overweight, and obesity (Class I, II, and III). The prevalence of OSA and PSG parameters were compared using the χ 2 test, logistic regression, multivariate analysis of variance, and linear regression models. p < 0.05 was considered significant.
Results:
Out of 604 children (342 male, 262 female, age range: 2-18), 488 (81%) had OSA. Most children were healthy weight (46%) or had obesity (38%). Prevalence of OSA was significantly different across BMI categories (p < 0.001), with highest odds of OSA in children with Class III Obesity (OR = 5.01, 95% CI [1.77, 21.04], p = 0.008). Compared to patients with healthy weight and no OSA, patients with Class II (OR = 2.67, 95% CI [1.16, 6.16], p = 0.02) and Class III Obesity (OR = 8.31, 95% CI [2.40, 28.81], p < 0.001) were more likely to have severe OSA (apnea-hypopnea index > 10). PSG parameters including obstructive apnea-hypopnea index, minimum SpO2, and mean CO2 differed among BMI categories (p < 0.001, p < 0.001, p = 0.003, respectively).
Conclusion:
The prevalence of OSA varies among weight groups. The severity of obesity is associated with increased odds of OSA and OSA severity. Obesity has a significant effect on minimum SpO2 saturation and mean CO2 levels. The utility of these findings in decision-making for PSG referral and surgical planning merits further investigation.
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