To determine if obesity is an independent risk factor for Obstructive sleep apnea-hypopnea syndrome(OSAHS) in a pediatric population.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) involves recurring episodes of total obstruction (apnea) or partial obstruction (hypopnea) of airways during sleep. In pediatrics, the link between obesity and obstructive sleep apnea-hypopnea syndrome (OSAHS) is still a controversy.Polysomnography was performed among 285 patients who habitually snored. 118 patients or 41% were found to be obese (BMI Z-score > 1.96). Among those obese, 34% were positive for obstructive sleep apnea-hypopnea syndrome (OSAHS) while 50% of non-obese also had obstructive sleep apnea-hypopnea syndrome (OSAHS).
The odds ratio (0.81) of BMI Z-score > 1.96 for obstructive sleep apnea-hypopnea syndrome (OSAHS) demonstrated neither a significant risk factor and predictor respectively for the presence and severity of obstructive sleep apnea-hypopnea syndrome (OSAHS) among the patients (p.v. 0.5229, [0.41, 1.62]). Tonsillar size (p.v. 0.0001, [2.07, 15.16]), the presence of witnessed apneas in the sleep history (p.v. 0.0190, [1.09, 5.38]), and presence of nasal congestion due to allergic rhinitis (p.v. 0.0055, [1.39, 16.31]) were found to be significant risk factors for the presence of obstructive sleep apnea-hypopnea syndrome (OSAHS).
In this study, BMI Z score, a measure of obesity was not shown to be a significant risk factor for OSAHS among pediatric population. Tonsillar size, after adjusting for other confounders remained significant independent predictor for AHI, the measure of presence and severity of OSAHS.
The spectrum of severity of pediatric OSAHS can lead to life threatening complications in children,delayed and missed diagnosis can lead to significant complications like neurobehavioral sequalae, failure to thrive and cor pulmonale. The correlation between obesity and obstructive sleep apnea is well established in adults, but data are inconsistent in children. Thus obesity remains controversial as a significant risk factor in the pediatric population.
Jenny Santos, No Financial Disclosure Information; No Product/Research Disclosure Information