OSA IN OBESE COMMUNITY-DWELLING CHILDREN: THE NANOS STUDY
Obstructive Sleep Apnea in Obese Community-Dwelling Children: The NANOS Study
María Luz Alonso-Álvarez, MD1,2,3; José Aurelio Cordero-Guevara, MD1,2,3; Joaquin Terán-Santos, MD1,2,3; Mónica Gonzalez-Martinez, MD1,4; María José Jurado-Luque, MD1,2,5; Jaime Corral-Peñafiel, MD1,2,6; Joaquin Duran-Cantolla, MD1,2,7; Leila Kheirandish-Gozal, MD, MSc8; David Gozal, MD8
1Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain; 2CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; 3Hospital Universitario de Burgos (HUBU), Burgos, Spain; 4Hospital Universitario Valdecilla, Santander, Cantabria, Spain; 5Hospital Val D′Hebron, Barcelona, Spain; 6Hospital San Pedro de Alcantara, Cáceres, Spain; 7Research Department, Hospital Universitario Araba, BioAraba, Universidad del Pais Vasco, Medicine Department, Vitoria, Spain; 8Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL
Obesity in children is assumed to serve as a major risk factor in pediatric obstructive sleep apnea syndrome (OSAS). However, the prevalence of OSAS in otherwise healthy obese children from the community is unknown.
To determine the prevalence of OSAS in obese children identified and recruited from primary care centers.
A cross-sectional, prospective, multicenter study. Spanish children ages 3–14 y with a body mass index (BMI) greater than or equal to the 95th percentile for age and sex were randomly selected, and underwent medical history, snoring, and Pediatric Sleep Questionnaire (PSQ) assessments, as well as physical examination, nasopharyngoscopy, and nocturnal polysomnography (NPSG) recordings.
Two hundred forty-eight children (54.4% males) with mean age of 10.8 ± 2.6 y were studied with a BMI of 28.0 ± 4.7 kg/m2 corresponding to 96.8 ± 0.6 percentile when adjusted for age and sex. The mean respiratory disturbance index (RDI), obstructive RDI (ORDI), and obstructive apnea-hypopnea index (OAHI) were 5.58 ± 9.90, 5.06 ± 9.57, and 3.39 ± 8.78/h total sleep time (TST), respectively. Using ≥ 3/h TST as the cutoff for the presence of OSAS, the prevalence of OSAS ranged from 21.5% to 39.5% depending on whether OAHI, ORDI, or RDI were used.
The prevalence of obstructive sleep apnea syndrome (OSAS) in obese children from the general population is high. Obese children should be screened for the presence of OSAS.
Alonso-Álvarez ML, Cordero-Guevara JA, Terán-Santos J, Gonzalez-Martinez M, Jurado-Luque MJ, Corral-Peñafiel J, Duran-Cantolla J, Kheirandish-Gozal L, Gozal D, for the Spanish Sleep Network. Obstructive sleep apnea in obese community-dwelling children: the NANOS study. SLEEP 2014;37(5):943-949.