A controlled study of sleep related disordered breathing in obese children

• Published in: Archives of disease in childhood Vol. 88; no. 12; pp. 1043 - 1047
• Main Authors: Wing, Y K, Hui, S H, Pak, W M, Ho, C K, Cheung, A, Li, A M, Fok, T F
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01-12-2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Adolescent; Age; apnoea index; Biological and medical sciences; BMI; Body Composition; Body Mass Index; Body Weight; central apnoea; Child; childhood; Childhood obesity; Childhood sleep disorders; Children & youth; Control Groups; Demographic aspects; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; ECG; EEG; electro-oculogram; electrocardiogram; electroencephalogram; electromyogram; EMG; end tidal CO2; EOG; Epidemiology; ETCO2; Ethnicity; Female; Health aspects; Humans; IBW; ideal weight for height; Male; Medical sciences; Metabolic diseases; MSLT; multiple sleep latency test; Nervous system (semeiology, syndromes); Neurology; OAI; Obesity; Obesity - complications; Obesity - pathology; Obesity in children; obstructive apnoea; obstructive apnoea index; ODI; Original; oxygen desaturation index; Palatine Tonsil; Pharyngeal Diseases - pathology; pharyngeal lymphoid tissues; polysomnographic studies; Population; PSG; RDI; Regression Analysis; respiratory disturbance index; Risk factors; SDB; Sleep; Sleep apnea; Sleep apnea syndromes; Sleep Apnea Syndromes - complications; Sleep Apnea Syndromes - pathology; sleep disordered breathing; Sleep disorders in children; sleep related disordered breathing; Studies; Terminology as Topic; United States > US; Human; Obesity; Pediatrics; Nervous system diseases; Nutrition disorder; Sleep disorder; Neurological disorder; Respiration; Child; Nutritional status
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.88.12.1043

Background: Unlike the adult sleep related disordered breathing (SDB) patients who are typically obese, the relation between obesity and childhood SDB is not clear. Aims: To investigate whether obese children are more at risk of obstructive SDB when compared to normal population, and whether this risk is potentiated by the presence of pharyngeal lymphoid tissue. Methods: Forty six obese children (age 10.8 (SD 2.3) years; BMI 27.4 (SD 5.1)), and 44 sex and age matched normal weight children (age 11.7 (SD 2.1) years; BMI 18 (SD 1.8)) were studied. All children underwent a set of physical examinations (including the upper airways) and sleep studies. Results: The obese children were different from the normal weight children in terms of type (predominantly obstructive), frequency, and severity of respiratory disturbances. Depending on the criteria used, 26% or 32.6% of obese children had SDB; 2.3% of normal controls had OAI ⩾1 and 4.5% had RDI ⩾5. Presence of SDB was related to presence of tonsils (size >2; range 0–4) (OR 12.67, 95% CI 2.14 to 75.17) and BMI (OR 1.20, 95% CI 1.08 to 1.33). Conclusions: Results suggest that obese children are at increased risk of obstructive SDB; the presence of any pharyngeal lymphoid tissue enlargement in obese children should therefore be aggressively managed.