Obstructive sleep apnea in children

OBJECTIVES/HYPOTHESIS: To study the correlation between obstructive sleep apnea (OSA), obesity, behavior, and quality of life. STUDY DESIGN: Case-control study of pediatric OSA documented by polysomnography at a tertiary-care hospital. METHODS: Caregivers signed a consent document and completed the Behavior Assessment System for Children (BASC-2) and the 18-item OSA Quality-of-Life Survey (OSA-18) questionnaires. Demographic and polysomnographic data were collected. Children were classified as obese with OSA, normal weight with OSA, or primary snoring (PS normal weight, sleep-disordered breathing, no OSA). The correlation between OSA severity and the degree of obesity as well as behavior and quality of life were compared among the three groups. A P value ≤.05 was considered significant. RESULTS: Seventy-three patients were included in the study. Thirty-five children were obese with OSA (48%), 21 were of normal weight with OSA (29%), and 17 were considered PS (23%). There was no linear correlation between the degree of obesity and OSA severity. Apnea/hypopnea index was significantly higher for OSA-obese versus OSA-normal weight children (20.0 vs. 9.0, P = .02). The OSA-18 total score and BASC-2 mean score was worse for the OSA-obese than the OSA-normal group (P = .01 for both). There was no difference in quality-of-life scores or behavioral scores between the OSA-normal and PS groups. CONCLUSIONS: The degree of obesity does not linearly predict OSA severity in children. Obese children have worse OSA, behavioral problems, and quality of life than normal-weight children. In normal-weight children with OSA or PS, behavior and quality-of-life scores are similar regardless of the severity of the sleep disorder. LEVEL OF EVIDENCE: 3b.