Effect of Increasing Body Mass Index on Obstructive Sleep Apnea in Children

Obesity is associated with obstructive sleep apnea in the adult and pediatric population. The aim of our study was to assess the association between increasing body mass index on the severity of obstructive sleep apnea in children. We reviewed retrospectively 740 children with symptoms suggestive of obstructive sleep apnea who underwent a sleep study at an inner city university hospital. Obstructive sleep apnea was defined as respiratory disturbance index of 5 per hour or more. Statistical analysis included chi square test and regression analysis. The results were as follows: 740 children, 56% were male. Mean age (±SD) 6.0 (±3.4) years. 66% were 6 years of age and younger and 34% were 7 years of age and older. 61% had a nap study positive for obstructive sleep apnea (63% of children 6 years and 69% 7 years). Mean body mass index z-score was +1.1 (± 1.5) (+1.0 (± 1.6) in children 6 years and +1.5 (±1.2) 7 years). In children 7 years of age and older there was a relationship between body mass index z-score and respiratory disturbance index (r= 0.188, p= 0.003). In children 6 years of age and younger there was no association. There was no relationship between body mass index and desaturation. Increasing body mass index is associated with increasing severity of obstructive sleep apnea in children 7 years of age and older.