Skip to main content
Erschienen in: Sleep and Breathing 2/2018

13.10.2017 | Pediatrics • Original Article

Prevalence of obstructive sleep apnea among obese toddlers and preschool children

verfasst von: Saadoun Bin-Hasan, MBBCh, FRCPC, Sherri Katz, MDCM, MSc, FRCPC, Zoe Nugent, MD, FRCPC, Joy Nehme, BSc, Zihang Lu, MSc, Abdullah Khayat, MBBCH, Suhail Al-Saleh, MBBS, MSc, FRCPC, Reshma Amin, MD, MSc, FRCPC, Indra Narang, MBBCH, FRCPCH, MD

Erschienen in: Sleep and Breathing | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Obstructive sleep apnea (OSA) is a common disorder estimated at 1–5% in the school-aged children. With the obesity prevalence reaching staggering rates globally, OSA in obese adolescents is estimated to be 4–5-folds higher than their lean peers. There is a paucity of data regarding obesity-related OSA in children 6 years and less. This is particularly relevant as OSA is associated with neurocognitive deficits. The aim of this study is to evaluate the prevalence of OSA among obese toddlers and preschool children and further to determine what other factors may be associated with the presence of OSA.

Methods

A retrospective study involving children ≤6 years, identified from two Canadian pediatric tertiary care centers who had an in-lab polysomnography (PSG). Obesity was defined by a BMI of > 95th percentile for age and gender or a z-score of > 2. OSA was diagnosed if the obstructive apnea-hypopnea index (OAHI) was greater than 2 events per hour.

Results

There were 60 participants included; the mean age was 4.4 years (standard deviation [SD] ± 1.7), mean BMI z-score was 3.0 (SD ± 1.2). Of these, 22/60 (36.6%) had OSA. Compared with the non-OSA group, the OSA group had a higher Epworth sleepiness score (p = 0.03) and were more likely to snore (p = 0.01).

Conclusion

Young obese children should be assessed for OSA. A history of snoring and daytime sleepiness may be useful indicators to facilitate triage for a PSG, especially in resource-limited settings.
Literatur
1.
Zurück zum Zitat Verhulst SL, Van Gaal L, De Backer W, Desager K (2008) The prevalence, anatomical correlates and treatment of sleep-disordered breathing in obese children and adolescents. Sleep Med Rev 12(5):339–346CrossRefPubMed Verhulst SL, Van Gaal L, De Backer W, Desager K (2008) The prevalence, anatomical correlates and treatment of sleep-disordered breathing in obese children and adolescents. Sleep Med Rev 12(5):339–346CrossRefPubMed
2.
Zurück zum Zitat de Onis M, Blossner M, Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92(5):1257–1264CrossRefPubMed de Onis M, Blossner M, Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92(5):1257–1264CrossRefPubMed
3.
Zurück zum Zitat Bradley TD, Floras JS (2009) Obstructive sleep apnoea and its cardiovascular consequences. Lancet 373(9657):82–93CrossRefPubMed Bradley TD, Floras JS (2009) Obstructive sleep apnoea and its cardiovascular consequences. Lancet 373(9657):82–93CrossRefPubMed
4.
Zurück zum Zitat Berry RB, Gamaldo CE, Harding SM, Brooks R, Lloyd RM, Vaughn BV et al (2015) AASM scoring manual version 2.2 updates: new chapters for scoring infant sleep staging and home sleep apnea testing. J Clin Sleep Med 11(11):1253–1254CrossRefPubMedPubMedCentral Berry RB, Gamaldo CE, Harding SM, Brooks R, Lloyd RM, Vaughn BV et al (2015) AASM scoring manual version 2.2 updates: new chapters for scoring infant sleep staging and home sleep apnea testing. J Clin Sleep Med 11(11):1253–1254CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Van Eyck A, Lambrechts C, Vanheeswijck L, Van Hoorenbeeck K, Haentjens D, Boudewyns A et al (2015) The role of nocturnal pulse oximetry in the screening for obstructive sleep apnea in obese children and adolescents. Sleep Med 16(11):1409–1412CrossRefPubMed Van Eyck A, Lambrechts C, Vanheeswijck L, Van Hoorenbeeck K, Haentjens D, Boudewyns A et al (2015) The role of nocturnal pulse oximetry in the screening for obstructive sleep apnea in obese children and adolescents. Sleep Med 16(11):1409–1412CrossRefPubMed
8.
Zurück zum Zitat Friedman M, Wilson M, Lin HC, Chang HW (2009) Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 140(6):800–808CrossRefPubMed Friedman M, Wilson M, Lin HC, Chang HW (2009) Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 140(6):800–808CrossRefPubMed
9.
Zurück zum Zitat Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J et al (2012) Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 130(3):576–584CrossRefPubMed Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J et al (2012) Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 130(3):576–584CrossRefPubMed
10.
Zurück zum Zitat Canapari CA, Hoppin AG, Kinane TB, Thomas BJ, Torriani M, Katz ES (2011) Relationship between sleep apnea, fat distribution, and insulin resistance in obese children. J Clin Sleep Med 7(3):268–273PubMedPubMedCentral Canapari CA, Hoppin AG, Kinane TB, Thomas BJ, Torriani M, Katz ES (2011) Relationship between sleep apnea, fat distribution, and insulin resistance in obese children. J Clin Sleep Med 7(3):268–273PubMedPubMedCentral
11.
Zurück zum Zitat Reade EP, Whaley C, Lin JJ, McKenney DW, Lee D, Perkin R (2004) Hypopnea in pediatric patients with obesity hypertension. Pediatr Nephrol 19(9):1014–1020CrossRefPubMed Reade EP, Whaley C, Lin JJ, McKenney DW, Lee D, Perkin R (2004) Hypopnea in pediatric patients with obesity hypertension. Pediatr Nephrol 19(9):1014–1020CrossRefPubMed
12.
Zurück zum Zitat Schwab RJ, Gupta KB, Gefter WB, Metzger LJ, Hoffman EA, Pack AI (1995) Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 152(5 Pt 1):1673–1689CrossRefPubMed Schwab RJ, Gupta KB, Gefter WB, Metzger LJ, Hoffman EA, Pack AI (1995) Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 152(5 Pt 1):1673–1689CrossRefPubMed
13.
Zurück zum Zitat Schwab RJ, Pasirstein M, Pierson R, Mackley A, Hachadoorian R, Arens R et al (2003) Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med 168(5):522–530CrossRefPubMed Schwab RJ, Pasirstein M, Pierson R, Mackley A, Hachadoorian R, Arens R et al (2003) Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med 168(5):522–530CrossRefPubMed
14.
Zurück zum Zitat Marcus CL, Moore RH, Rosen CL, Giordani B, Garetz SL, Taylor HG et al (2013) A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med 368(25):2366–2376CrossRefPubMedPubMedCentral Marcus CL, Moore RH, Rosen CL, Giordani B, Garetz SL, Taylor HG et al (2013) A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med 368(25):2366–2376CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Mathew JL, Narang I (2014) Sleeping too close together: obesity and obstructive sleep apnea in childhood and adolescence. Paediatr Respir Rev 15(3):211–218PubMed Mathew JL, Narang I (2014) Sleeping too close together: obesity and obstructive sleep apnea in childhood and adolescence. Paediatr Respir Rev 15(3):211–218PubMed
16.
Zurück zum Zitat Katz SL, Witmans M, Barrowman N, Hoey L, Su S, Reddy D et al (2014) Paediatric sleep resources in Canada: the scope of the problem. Paediatr Child Health 19(7):367–372CrossRefPubMedPubMedCentral Katz SL, Witmans M, Barrowman N, Hoey L, Su S, Reddy D et al (2014) Paediatric sleep resources in Canada: the scope of the problem. Paediatr Child Health 19(7):367–372CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320(7244):1240–1243CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320(7244):1240–1243CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Standards and indications for cardiopulmonary sleep studies in children (1996) American Thoracic Society. Am J Respir Crit Care Med 153(2):866–878CrossRef Standards and indications for cardiopulmonary sleep studies in children (1996) American Thoracic Society. Am J Respir Crit Care Med 153(2):866–878CrossRef
19.
Zurück zum Zitat Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545CrossRefPubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545CrossRefPubMed
20.
Zurück zum Zitat Melendres MC, Lutz JM, Rubin ED, Marcus CL (2004) Daytime sleepiness and hyperactivity in children with suspected sleep-disordered breathing. Pediatrics 114(3):768–775CrossRefPubMed Melendres MC, Lutz JM, Rubin ED, Marcus CL (2004) Daytime sleepiness and hyperactivity in children with suspected sleep-disordered breathing. Pediatrics 114(3):768–775CrossRefPubMed
21.
Zurück zum Zitat Chan EY, Ng DK, Chan CH, Kwok KL, Chow PY, Cheung JM et al (2009) Modified Epworth Sleepiness Scale in Chinese children with obstructive sleep apnea: a retrospective study. Sleep Breath 13(1):59–63CrossRefPubMed Chan EY, Ng DK, Chan CH, Kwok KL, Chow PY, Cheung JM et al (2009) Modified Epworth Sleepiness Scale in Chinese children with obstructive sleep apnea: a retrospective study. Sleep Breath 13(1):59–63CrossRefPubMed
23.
Zurück zum Zitat Sproson EL, Hogan AM, Hill CM (2009) Accuracy of clinical assessment of paediatric obstructive sleep apnoea in two English centres. J Laryngol Otol 123(9):1002–1009CrossRefPubMed Sproson EL, Hogan AM, Hill CM (2009) Accuracy of clinical assessment of paediatric obstructive sleep apnoea in two English centres. J Laryngol Otol 123(9):1002–1009CrossRefPubMed
24.
Zurück zum Zitat Mallory GB Jr, Fiser DH, Jackson R (1989) Sleep-associated breathing disorders in morbidly obese children and adolescents. J Pediatr 115(6):892–897CrossRefPubMed Mallory GB Jr, Fiser DH, Jackson R (1989) Sleep-associated breathing disorders in morbidly obese children and adolescents. J Pediatr 115(6):892–897CrossRefPubMed
26.
Zurück zum Zitat Gislason T, Benediktsdottir B (1995) Snoring, apneic episodes, and nocturnal hypoxemia among children 6 months to 6 years old. An epidemiologic study of lower limit of prevalence. Chest 107(4):963–966CrossRefPubMed Gislason T, Benediktsdottir B (1995) Snoring, apneic episodes, and nocturnal hypoxemia among children 6 months to 6 years old. An epidemiologic study of lower limit of prevalence. Chest 107(4):963–966CrossRefPubMed
27.
Zurück zum Zitat Gozal D (1998) Sleep-disordered breathing and school performance in children. Pediatrics 102(3 Pt 1):616–620CrossRefPubMed Gozal D (1998) Sleep-disordered breathing and school performance in children. Pediatrics 102(3 Pt 1):616–620CrossRefPubMed
28.
Zurück zum Zitat Redline S, Tishler PV, Schluchter M, Aylor J, Clark K, Graham G (1999) Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med 159(5 Pt 1):1527–1532CrossRefPubMed Redline S, Tishler PV, Schluchter M, Aylor J, Clark K, Graham G (1999) Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med 159(5 Pt 1):1527–1532CrossRefPubMed
29.
Zurück zum Zitat Xu Z, Jiaqing A, Yuchuan L, Shen K (2008) A case-control study of obstructive sleep apnea-hypopnea syndrome in obese and nonobese Chinese children. Chest 133(3):684–689CrossRefPubMed Xu Z, Jiaqing A, Yuchuan L, Shen K (2008) A case-control study of obstructive sleep apnea-hypopnea syndrome in obese and nonobese Chinese children. Chest 133(3):684–689CrossRefPubMed
Metadaten
Titel
Prevalence of obstructive sleep apnea among obese toddlers and preschool children
verfasst von
Saadoun Bin-Hasan, MBBCh, FRCPC
Sherri Katz, MDCM, MSc, FRCPC
Zoe Nugent, MD, FRCPC
Joy Nehme, BSc
Zihang Lu, MSc
Abdullah Khayat, MBBCH
Suhail Al-Saleh, MBBS, MSc, FRCPC
Reshma Amin, MD, MSc, FRCPC
Indra Narang, MBBCH, FRCPCH, MD
Publikationsdatum
13.10.2017
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 2/2018
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-017-1576-4

Weitere Artikel der Ausgabe 2/2018

Sleep and Breathing 2/2018 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Review

Sleep-disordered breathing in patients with neuromuscular disease

Sleep Breathing Physiology and Disorders • Original Article

Chronic intermittent hypoxia exposure induces kidney injury in growing rats

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.