Overweight, Obesity in Teens Linked to Increased Risk for Obstructive Sleep Apnea Syndrome

Laurie Barclay, MD

December 21, 2009

December 21, 2009 — Similar to adults, adolescents have an increased risk of having obstructive sleep apnea syndrome (OSAS) in association with overweight and obesity, according to the results of a study reported in the December issue of the Journal of Clinical Sleep Medicine.

"Overweight and obesity are thought to increase the risk of...OSAS among children," write Mark J. Kohler, PhD, from University of Adelaide in Adelaide, Australia, and colleagues. "However, previous results have been inconsistent and appear to be confounded by both ethnicity and the different ages of children studied. To determine whether the association between excess weight and OSAS varies with age across childhood, we assessed polysomnographic data from a series of Caucasian children and adolescents referred for clinical evaluation of snoring."

The investigators performed polysomnography in 234 children aged 2.0 to 18.0 years who were referred for overnight evaluation of suspected OSAS, and they determined severity of OSAS as a function of body mass index (BMI) and age.

For each SD increase in BMI z-score, the risk for OSAS among adolescents (age ≥ 12 years) was increased 3.5-fold. Among younger children, however, the risk for OSAS was not significantly increased with increasing BMI.

"Similar to adults, adolescent children show an increased risk for having OSAS in association with overweight and obesity," the study authors write. "For Caucasian children, overweight and obesity should be considered a significant risk for OSAS among adolescents or from age 12 years, especially when in combination with other established risk factors, including snoring and adenotonsillar hypertrophy."

Limitations of this study include lack of generalizability because of Caucasian population referred for suspected upper airway obstruction and possible selection bias in referral of younger children vs adolescents.

"Clearly the etiology of OSAS is multifactorial, comprising an interaction of physiologic and anatomic factors," the study authors write. "The identification of these factors will continue to be an active and important field of research given the striking morbidity associated with OSAS. However, researchers and clinicians alike should realize that such factors appear to change with age during childhood."

This was not an industry-supported study, and the study authors have disclosed no relevant financial relationships.

J Clin Sleep Med. 2009;5:506-511.

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