Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
June 12, 2026Pediatric ResearchOpen Access

Overweight and obesity linked to exacerbated sympathetic dominance in children with OSA.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Pediatric obstructive sleep apnea is linked to autonomic dysfunction and impaired quality of life, but whether weight status modifies the effect of disease severity on heart rate variability and quality of life was unclear.

Does weight status modify the impact of obstructive sleep apnea severity on heart rate variability and quality-of-life in children?

Population

115 children with OSA

Comparison

Normal-weight vs overweight vs obesity groups

Design

Retrospective cohort study

Key result

Overweight and obesity significantly modified the impact of the apnea-hypopnea index on the LF/HF ratio (p=0.02), indicating exacerbated sympathetic dominance in heavier children with obstructive sleep apnea.

Authors

LLLi‐Ang LeeWLW Y LinLHLi‐Jen Hsin

Discussion

Loading...

Member takes

Overview

Weight status may modify autonomic dysfunction in pediatric OSA; hypothesis-generating for targeted management pending prospective trials.

Key Points

  • The aim is to investigate how weight status influences the relationship between OSA severity and heart rate variability and quality of life in children.
  • Retrospective cohort study with 115 children diagnosed with OSA.
  • Categorized by body mass index z-score into normal-weight, overweight, and obesity groups.
  • Used hierarchical multiple regression to assess how weight status modifies effects on heart rate variability and quality of life.
  • Children categorized as overweight and obese exhibited significantly higher apnea-hypopnea index (AHI) and reduced heart rate variability.
  • Overweight and obesity significantly modified the relationship between AHI and heart rate variability (p = 0.02).
  • No interaction between weight status and AHI on quality of life was observed despite exacerbated autonomic dysfunction.

Study Design

Type

Cohort (n=115)

Multicenter

No

Structured PICO

Does weight status modify the impact of obstructive sleep apnea severity on heart rate variability and quality-of-life in children?

P
Population
115 children aged 5 to 12 years with obstructive sleep apnea, categorized by weight status, who underwent overnight polysomnography and heart rate variability assessment.
E
Exposure
Overweight and obesity (categorized by BMI z-score ≥1.0 and ≥2.0 respectively)
C
Comparator
Normal-weight children (BMI z-score <1.0) with obstructive sleep apnea
O
Outcome
Moderating effect of weight status on the relationship between the apnea-hypopnea index (AHI) and both the low-frequency/high-frequency (LF/HF) ratio and total OSA-18 scoresurrogate

Main Result

Effect estimate: ΔR2 = 0.052

p-value: p=0.02

Overweight and obesity significantly exacerbate autonomic dysfunction in children with obstructive sleep apnea, amplifying sympathetic predominance in response to respiratory severity.

Limitations

  • Cross-sectional and observational design limits the ability to establish definitive causal relationships.
  • Groups were not physically matched for AHI.
  • HRV was assessed from a single night of polysomnography, which may be influenced by night-to-night variability.
  • The OSA-18 questionnaire relies on subjective caregiver perception.
  • Single-center setting and predominantly Asian (Taiwanese) ethnic composition may limit generalizability.

Cite This Study

Lee et al. (2026) conducted a cohort in Obstructive sleep apnea (OSA) (n=115). Overweight and obesity (Weight status) vs. Normal-weight was evaluated on Moderating effect of weight status on the relationship between AHI and the LF/HF ratio (ΔR2 = 0.052, p=0.02). Overweight and obesity significantly modified the impact of the apnea-hypopnea index on the LF/HF ratio (p=0.02), indicating exacerbated sympathetic dominance in heavier children with obstructive sleep apnea.

synapsesocial.com/papers/6a2ba5068101cf8926f034cahttps://doi.org/10.1038/s41390-026-05079-0
View Full Paper
Ask AI
Bookmark
Share