Obstructive sleep apnea in children and adolescents with and without obesity

• Published in: European archives of oto-rhino-laryngology 2019-03, Vol.276 (3), p.871-878
• Main Authors: Andersen, Ida Gillberg, Holm, Jens-Christian, Homøe, Preben
• Format: Article
• Language: English
• Subjects: Head and Neck Surgery; Medicine; Medicine & Public Health; Miscellaneous; Neurosurgery; Otorhinolaryngology
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-019-05290-2

Purpose To investigate the prevalence of obstructive sleep apnea (OSA) in children referred for obesity treatment, and to compare the prevalence with that of a normal-weight group. Moreover, we examined the association between Body Mass Index Standard Deviation Score (BMI SDS) and the Apnea–Hypopnea Index (AHI). Methods This cross-sectional study included 139 children aged 7–18 years with overweight/obesity (BMI SDS >1.28) recruited from an obesity treatment clinic. The normal-weight group consisted of 33 children (BMI SDS ≤ 1.28) aged 7–18 years recruited from schools. Sleep examinations were performed using a type 3 portable sleep monitor (Nox T3). OSA was defined as AHI ≥ 2. Height and weight were measured and the tonsillar size was clinically estimated using the Brodsky scale. Results The OSA prevalence was 44.6% in children with overweight/obesity compared with 9.1% in the normal-weight group ( p  = 0.0002), and the relative risk of OSA was 4.9 (95% CI 1.6–14.7). In a logistic regression, a one-unit increase in the BMI SDS increased the odds of having OSA by a factor of 1.92 independent of age, sex, tonsillar hypertrophy, and asthma (95% CI 1.33–2.76, p  = 0.0005). A generalized linear regression adjusted for the same variables revealed an association between BMI SDS and AHI (a one-unit increase in the BMI SDS equaled an average increase in the AHI of 35% (95% CI 19–53%, p