TY - JOUR
T1 - Obstructive Sleep Apnea
T2 - Differences between Normal-Weight, Overweight, Obese, and Morbidly Obese Children
AU - Scott, Brian
AU - Johnson, Romaine F.
AU - Mitchell, Ron B.
N1 - Publisher Copyright:
© American Academy of Otolaryngology-Head and Neck Surgery Foundation 2016.
PY - 2016/5
Y1 - 2016/5
N2 - Introduction The severity of obstructive sleep apnea in children determines perioperative management and is an indication for postoperative polysomnography. The relationship between increasing weight and sleep apnea severity in children remains unclear. Objectives To compare demographic, clinical, and polysomnography parameters in normal-weight, overweight, obese, and morbidly obese children, as well as identify demographic factors that predict sleep apnea severity. Study Design Case series with chart review. Setting Academic children's hospital. Methods A retrospective chart review of 290 children aged 2 to 18 years who underwent polysomnography at an academic children's hospital was performed. Demographics, clinical findings, and polysomnographic parameters were recorded. Children were categorized as normal weight, overweight, obese, or morbidly obese. Differences were assessed using linear and logistical regression models. Significance was set at P <.05. Results Morbidly obese were older than normal-weight children (mean, 8.0 ± 0.5 years vs 5.8 ± 0.3 years; P <.001) and less likely to have a normal polysomnogram (16% vs 48%; P =.02). There were no differences in sex, ethnicity, birth status (term or preterm), or tonsil size between normal-weight, overweight, obese, and morbidly obese children. Sleep efficiency and percentage of time in rapid eye movement were decreased in morbidly obese compared with other children (P <.05). The apnea-hypopnea index was positively correlated with increasing body mass index z score only as a function of increasing age (P <.001). Conclusion Obstructive sleep apnea severity is correlated with a combination of increasing age and weight but not with either variable independently. This study suggests that obese and morbidly obese older children are most likely to have severe obstructive sleep apnea.
AB - Introduction The severity of obstructive sleep apnea in children determines perioperative management and is an indication for postoperative polysomnography. The relationship between increasing weight and sleep apnea severity in children remains unclear. Objectives To compare demographic, clinical, and polysomnography parameters in normal-weight, overweight, obese, and morbidly obese children, as well as identify demographic factors that predict sleep apnea severity. Study Design Case series with chart review. Setting Academic children's hospital. Methods A retrospective chart review of 290 children aged 2 to 18 years who underwent polysomnography at an academic children's hospital was performed. Demographics, clinical findings, and polysomnographic parameters were recorded. Children were categorized as normal weight, overweight, obese, or morbidly obese. Differences were assessed using linear and logistical regression models. Significance was set at P <.05. Results Morbidly obese were older than normal-weight children (mean, 8.0 ± 0.5 years vs 5.8 ± 0.3 years; P <.001) and less likely to have a normal polysomnogram (16% vs 48%; P =.02). There were no differences in sex, ethnicity, birth status (term or preterm), or tonsil size between normal-weight, overweight, obese, and morbidly obese children. Sleep efficiency and percentage of time in rapid eye movement were decreased in morbidly obese compared with other children (P <.05). The apnea-hypopnea index was positively correlated with increasing body mass index z score only as a function of increasing age (P <.001). Conclusion Obstructive sleep apnea severity is correlated with a combination of increasing age and weight but not with either variable independently. This study suggests that obese and morbidly obese older children are most likely to have severe obstructive sleep apnea.
KW - obesity
KW - obstructive sleep apnea
KW - pediatrics
KW - polysomnography
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U2 - 10.1177/0194599816636626
DO - 10.1177/0194599816636626
M3 - Article
C2 - 26980917
AN - SCOPUS:84968735785
SN - 0194-5998
VL - 154
SP - 936
EP - 943
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 5
ER -