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Community child health, public health, and epidemiology
A controlled study of sleep related disordered breathing in obese children
  1. Y K Wing1,
  2. S H Hui2,
  3. W M Pak3,
  4. C K Ho1,
  5. A Cheung1,
  6. A M Li2,
  7. T F Fok2
  1. 1Department of Psychiatry, Prince of Wales and Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China
  2. 2Department of Paediatrics, Prince of Wales and Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China
  3. 3Department of Ear, Nose and Throat, Prince of Wales and Shatin Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China
  1. 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; ykwingcuhk.edu.hk

Abstract

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.

  • childhood
  • sleep related disordered breathing
  • obesity
  • pharyngeal lymphoid tissues
  • 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

https://doi.org/10.1136/adc.88.12.1043

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