Obesity increases the risk for persisting obstructive sleep apnea after treatment in children

SummaryObjectiveTo evaluate the impact of obesity at diagnosis on treatment outcomes in paediatric obstructive sleep apnea (OSA).MethodsChildren were included if they had both diagnostic and follow-up studies for OSA. Anthropological and polysomnographic data were collected at the time of both studies. Polysomnograms were scored using standard criteria and OSA was defined as a respiratory disturbance index (RDI) ≥5. Obesity was defined as a body mass index standard deviation (z-)score (BMIsds) greater than 2, adjusted for age and gender.ResultsFor 69 children (49 males), mean age was 7.1 ± 4.2 years and 29 (42%) children were obese. There was no significant difference in RDI between obese and non-obese children at diagnostic study. Following adenotonsillectomy the obese children had a significantly higher mean RDI (10.7 ± 15.6 versus 3.7 ± 4.3; p = 0.01). Disease resolution occurred in 77.5% of non-obese compared to 45% of obese children (p = 0.011). The odds ratio (OR) for persistent OSA in obese compared to non-obese children was 4.2 (95% CI: 1.5–11.9; p = 0.005). Using initial RDI as a covariate, these data show that obesity in children has an adjusted OR for persistent OSA after adenotonsillectomy 3.7 (95% CI: 1.3–10.8, p = 0.016).ConclusionFor children, obesity at the time of diagnosis is a major risk for persisting OSA after treatment, regardless of the severity of initial disease.