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Community child health, public health, and epidemiology
A controlled study of sleep related disordered breathing in obese children
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  • Published on: 19 February 2004
    Author's reply
    • Yun Kwok Wing, Director of Sleep Assessment Unit
    • Other Contributors:
      • Albert Li

    Dear Editor

    Thank you for the useful and thought provoking comment made by JM Howard.[1]

    There is no doubt that the control mechanism for childhood obstructive sleep apnoea (OSA) is multifactorial. Obesity as a cause is not simply a mechanical imbalance of the equilibrium and there is increasing evidence to suggest neuromuscular and hormonal factors coming into play. Sex hormone involvement in OSA is be...

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    Conflict of Interest:
    None declared.
  • Published on: 9 January 2004
    This may be due to increased testosterone.

    Dear Editor

    Regarding the article by Wing et al.[1] It is my hypothesis that the percentage of individuals of higher testosterone is increasing worldwide, more in some places than others. I suggest this is the cause of the "secular trend." Among a number of characteristics that may result from this increase in numbers of individuals of higher testosterone, I suggest increasing obesity is one. An obesity epidemi...

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    Conflict of Interest:
    None declared.