Introduction Obstructive sleep apnoea hypopnoea syndrome (OSAHS) is common in children with obesity and is associated with long-term morbidity. Understanding risk factors that predispose to OSAHS in children with obesity may help improve targeted screening with sleep studies and is likely to lead to early detection and intervention. The aim of this multicentre retrospective case-cohort study was to assess how age, sex, BMI, and adenotonsillar hypertrophy presence correlate with OSAHS diagnosis in children with obesity.^1–3

Methods This was a retrospective review of medical notes of children with obesity, as defined by WHO (BMI-z-score >3 for children 0–5 yo, BMI-z-score >2 for children >5 yo) referred to three regional hospitals for sleep study between January 2020 and June 2023. Children with significant co-morbidities such as trisomy 21 or neuro-disability were excluded.

Results 46 children (16 female: 30 male) with median age (range) of 9 years (2–16) and median BMI-z-score of 3.34 (2.12–7.67) were included in the analysis. 18 had adenotonsillar enlargement. 12 had history of adenotonsillectomy. Mean (standard deviation) Obstructive Apnoea Hypopnoea Index (OAHI) was 3.198 events/hr (3.918). 19 children had normal OAHI, 16 had mild OSAHS and 11 had moderate to severe OSAHS. Diagnosis of OSAHS was independent of age. Boys had significantly higher mean OAHI than girls (4.073 Vs 1.556 respectively, p=0.009). BMI-z-score moderately correlated with OAHI, (rho=0.362, p=0.040). There was no difference in mean BMI-z-score between normal, mild, and moderate-severe OSAHS groups (p=0.116). OSAHS was more common in children with adenotonsillar enlargement (Odds Ratio=10.5, 95% CI of 2.15–51.281, p=0.002)

Discussion Male sex, adenotonsillar enlargement, and higher BMI-z-score are associated with OSA diagnosis in children with obesity.

References

1. Bachrach K, et al. Ann Otol Rhinol Laryngol 2022;131:520–6.

2. Kohler M, et al. J Clin Sleep Med 2008;04:129–36.

3. Supriyatno B, et al. Paediatr Respir Rev 2010;11:S107