ORIGINAL ARTICLE

A controlled study of sleep related disordered breathing in obese children

Y K Wing¹, S H Hui², W M Pak³, C K Ho¹, A Cheung¹, A M Li², T F Fok²

¹ Department of Psychiatry, Prince of Wales and Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China
² Department of Paediatrics, Prince of Wales and Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China
³ Department of Ear, Nose and Throat, Prince of Wales and Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China

Correspondence to:
Correspondence to:
Professor Y K Wing
Director of Sleep Assessment Unit, Department of Psychiatry, Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China; ykwing{at}cuhk.edu.hk

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.

Keywords: childhood; sleep related disordered breathing; obesity; pharyngeal lymphoid tissues

Abbreviations: AI, apnoea index; BMI, body mass index; CA, central apnoea; ECG, electrocardiogram; EEG, electroencephalogram; EMG, electromyogram; EOG, electro-oculogram; ETCO2, end tidal CO2; IBW, ideal weight for height; MSLT, multiple sleep latency test; OA, obstructive apnoea; OAI, obstructive apnoea index; ODI, oxygen desaturation index; PSG, polysomnographic studies; RDI, respiratory disturbance index; SDB, sleep disordered breathing

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This may be due to increased testosterone.

James M. Howard

ADC Online, 9 Jan 2004 [Full text]

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Yun Kwok Wing, et al.

ADC Online, 19 Feb 2004 [Full text]