[Differential study on sleep architecture and sleep subtypes in children with OSA in different weight states]

Objective:To compare sleep architecture characteristics and the incidence of sleep subtypes in children with obstructive sleep apnea（OSA） across different weight categories. Methods:We retrospectively analyzed children who underwent polysomnographic monitoring in our hospital from January 1, 2017 to December 30, 2022, categorizing them as normal weight（Group A）, underweight（Group B）, overweight（Group C）, and obese（Group D）. We then compared differences in sleep structure, respiratory events, oxygenation indices, and sleep subtypes between these groups. Results:Statistical analysis revealed significant gender differences between Groups A and D, B and C, and B and D. Groups A and B exhibited higher percentages of REM sleep than Group D（P<0.05）. Respiratory indices, including OAHI, AHI, ODI, HI, and NREMAHI, were significantly elevated in Group D compared to the other groups（P<0.05）. REMAHI was lower in Groups A and C compared to Group D（P<0.05）. The minimum oxygen saturation, minimum oxygen saturation during NREM sleep, and minimum oxygen saturation during REM sleep were lower in Group D than in Group A（P<0.05）. The proportion of children with severe OSA was higher in Group D than in the other groups（P<0.05）. There was no significant difference in adenoid size distribution among the four groups. No significant difference was found in the incidence of R-OSA（REM-related OSA） among the four groups. The incidence of P-OSA（positional OSA） was higher in Group C than in Groups A and B（P<0.05） and higher in Group D than in Groups A and B（P<0.05）. Conclusion:The prevalence of P-OSA was higher among overweight and obese groups, with the obese group experiencing the highest rates of severe OSA, more frequent hypoxemia, and reduced REM sleep duration.