Source:Sleep Medicine
Author(s): Joanna E. MacLean, Kristie DeHaan, Tamya Chowdhury, Joy Nehme, Glenda N. Bendiak, Lynda Hoey, Linda Horwood, Hans Pasterkamp, Valerie Kirk, Evelyn Constantin, Sherri L. Katz
ObjectiveTo determine the scope of sleep concerns, clinical features and polysomnography results and to identify factors that predict obstructive sleep apnea (OSA) in a cohort of children with obesity.MethodsThe study was a multi-center retrospective chart review. Data were collected from 3 pediatric sleep laboratories over a 2-year period for all children 8-16 years of age with a BMI ≥95th centile undergoing polysomnography. Data sources included clinical charts and polysomnography results. Clinical and polysomnography factors were examined as predictors of OSA.ResultsA total of 210 children met inclusion criteria and 205 had sufficient data for analysis. The mean age was 12.5 ± 2.7 years; 65% were male. Multiple sleep concerns and comorbidities were reported in most children (90% and 91% respectively). Polysomnography identified OSA in 44% of children; 28% of children demonstrated moderate/severe OSA. Mouth breathing/nasal congestion (OR 0.33, 95%CI 0.18-0.61), syndrome/multiple anomalies (OR 2.4, 95%CI 1.22-4.93) and family history of OSA (OR 2.7, 95% CI 1.2-5.8) or sleep problems (OR 12.4, 95% CI 1.5, 99.6) were the only factors predictive of OSA. Polysomnographic oxygen desaturation index <6 events/h showed an odds ratio of 4.96 (95% CI 2.27-10.86) for the absence of OSA.ConclusionsChildren with obesity undergoing polysomnography are medically complex with multiple sleep concerns including a high burden of daytime symptoms; just under half demonstrate polysomnographic features of OSA. Earlier identification of OSA, recognition of non-OSA sleep concerns, and treatment strategies to improve sleep may contribute to overall health outcomes for children with obesity.
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