0864 Obesity in Pediatric Sleep Medicine Evaluations: Insights from a Real-World Multicenter Analysis

Abstract Introduction Sleep disorders have been reported disproportionately among children with overweight/obesity, however, the exact prevalence of overweight/obesity in pediatric sleep clinics is poorly defined. Further, evidence on the burden of obesity among children undergoing evaluation in pediatric sleep medicine practices is lacking. We hypothesize that the prevalence of children and adolescents presenting with overweight/obesity to sleep clinics is higher compared to other pediatric subspecialty clinics across three large tertiary pediatric sleep centers. Methods Retrospective review of electronic health records of children under 18 years of age who had new patient visits with documented BMI at three tertiary pediatric hospitals (Rady Children’s Hospital San Diego San Diego, Seattle Children’s Hospital Seattle and Monroe Carell Jr. Children’s Hospital at Vanderbilt Nashville) across the following subspecialty clinics: sleep medicine, pulmonology, gastroenterology, endocrinology, and cardiology. A BMI percentile of ≥85 was used to define pediatric overweight/obese. Chi-square statistic was used to compare the proportion of children with overweight/obesity and obesity at each subspecialty clinic compared to those evaluated in the sleep medicine clinic. In sleep medicine clinics, chi-square tests were used to compare the proportions of overweight/obesity by age group ( 5 years, 5-11 years, and ≥12 years). Results We retrieved a total of 223,840 new encounters from three pediatric tertiary hospitals (San Diego n=76,714, Seattle n=57,863, and Nashville n=89,263). The prevalence of overweight/obesity in sleep clinics was 55.5% in San Diego, 47.2% in Seattle, and 50.1% in Nashville. These prevalence rates were significantly higher than those in all other subspecialty clinics across all centers (p-value 0.01), including endocrinology (33.5-47.5%), pulmonology (35.5-38.7%), gastroenterology (30.1-34.8%), and cardiology (26.9-29.6%). An association between patient age range and overweight/obese status was also observed (p-value 0.01), with adolescents (12 years old) having the highest rate of overweight/obesity (56.4-63.5%). Conclusion Our study reveals that pediatric sleep clinics evaluate a disproportionately high population of children with overweight/obesity. These findings support an opportunity for pediatric sleep specialists to create targeted intervention strategies to treat overweight/obesity. Support (if any) Supported by HRSA A2T2MC0007 and the Robert A. Winn Excellence in Clinical Trials Award Program