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Obstructive sleep apnea in children: prevalence and association with overweight and obesity
Ingibjorg Ingolfsdottir1,2, Laufey Hrolfsdottir1,3, Groa Bjork Johannesdottir1
1Akureyri Hospital, Akureyri, Iceland.
Insights
Obstructive sleep apnea (OSA) is common in young children, with overweight and obesity significantly increasing the risk. Early identification and management are crucial for children's health.
Area of Science:
- Pediatric Sleep Medicine
- Childhood Obesity Research
- Public Health
Background:
- Obstructive sleep apnea (OSA) is an underdiagnosed condition in children, potentially impacting long-term health.
- While obesity is a known OSA risk factor in adults, its association in children requires further investigation.
Purpose of the Study:
- To evaluate the prevalence of OSA in young children aged 4-9 years.
- To determine the association between weight gain, overweight, obesity, and OSA in this pediatric population.
Main Methods:
- A cross-sectional study involving 371 children (4-9 years old) over one year.
- Sleep evaluated using the pediatric-sleep-questionnaire (PSQ) and home sleep tests.
- Body Mass Index (BMI) z-scores used to assess overweight/obesity; multivariable regression analyzed OSA association.
Main Results:
- The prevalence of undiagnosed OSA was 22.7%, with moderate-to-severe OSA at 16.2% and 6.5% respectively.
- Increased BMI z-score correlated with higher odds of moderate/severe OSA (OR=1.35 per unit increase).
- Overweight and obesity were associated with nearly triple the risk of moderate/severe OSA compared to normal weight.
Conclusions:
- OSA prevalence in young children is higher than previously estimated.
- Weight gain, overweight, and obesity are significantly associated with OSA diagnoses in children.
- Findings highlight the importance of weight management in pediatric OSA prevention and treatment.
Introduction:
Obstructive sleep apnea (OSA) is an underdiagnosed health condition and in young children, if untreated, may have negative effects on mental and physical health. Although obesity is recognized as a major risk factor for OSA in adults, the association between weight and OSA has not been as well documented in children. This study was conducted to evaluate prevalence of OSA in young children and if there is an association with weight gain, overweight and/or obesity.
Methods:
Cross-sectional study, conducted over period of one-year included 29% (n = 371) of young children (4-9-years old) living within the general population in the recruitment area. Sleep was evaluated subjectively with the pediatric-sleep-questionnaire (PSQ) and objectively using a home sleep test. Two-nights of >4-h of sleep-duration was required for diagnosis of OSA. Overweight and obesity was evaluated using BMI z-score. Multivariable log-binomial regression analysis was used to assess the relationship between OSA and overweight/obesity. The analyses were adjusted for age, sex, history of asthma/allergies and prior adenotonsillar surgery.
Results:
Undiagnosed OSA is prevalent in young children or 22.7%; with prevalence of moderate-OSA 16.2% and severe-OSA 6.5%. Each one-unit increase in BMI z-score was associated with 1.35-times (CI95%:1.22, 1.50) higher risk of having moderate/severe OSA. Childhood overweight (RR = 2.71; CI95%1.76, 4.16) and obesity (RR = 2.80; CI95%1.75, 4.49) were associated with almost three times the increase higher risk of having moderate/severe OSA. When analyzing BMI z-score from 18 months of age to current age (ΔBMI z-score), each one-unit increase in BMI z-score was associated with 1.24-times (CI95%: 1.08, 1.41) higher risk of having moderate/severe OSA.
Conclusions:
The prevalence of OSA in young children is higher than previously reported, with weight gain, overweight, and obesity strongly associated with OSA diagnoses.
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