Sleep associated gas exchange abnormalities in children and adolescents with habitual snoring.

STUDY OBJECTIVES: The purpose of this study was to describe the prevalence of polysomnographically diagnosed OSAS and to describe the severity of sleep associated gas exchange abnormalities (SAGEA) in habitually snoring children. We hypothesized that there would be a high prevalence of OSAS in obese children with habitual snoring and that the most overweight children would have the most significant SAGEA. DESIGN: Retrospective chart review. MEASUREMENTS AND RESULTS: Nocturnal polysomnography (NPSG) data from 114 children and adolescents referred for habitual snoring were examined. 74 of the subjects were male (65%), average age of 9.78 +/- 4.19 years, average AHI 13.51 +/- 20.25, mean BMI z-score 1.79 +/- 1.18. BMI z-scores correlated positively with severity of OSAS (P < 0.05) such that children with progressive degrees of obesity had more frequent respiratory events during sleep. Additionally, severity of sleeping hypercapnea as measured by percent of total sleep time with EtCO(2) values above 50 mm Hg was more severe with progressive degrees of obesity. Likewise, all measures of oxyhemoglobin desaturation were more severe with progressive degrees of obesity. Positive correlations between the severity of SAGEA and degree of obesity remained even after controlling for the severity of OSAS. CONCLUSIONS: OSAS is highly prevalent in children referred to a pediatric sleep center with complaints of habitual snoring across a wide spectrum of weight categories. SAGEA increases with progressive obesity even when controlling for the severity of OSAS suggesting that obesity is an independent risk factor for SAGEA. Furthermore, because obese children frequently have SAGEA, capnography should be obtained during NPSG when possible.

Symptoms of sleep apnea and polysomnography as predictors of poor quality of life in overweight children and adolescents.

OBJECTIVE: The goal of this study was to examine the relationship between quality of life (QOL) and symptoms of obstructive sleep apnea (OSA) as well as objectively measured severity of OSA using polysomnography (PSG) in a cohort of overweight and at risk for overweight children and adolescents. METHODS: One hundred and fifty-one overweight subjects [90 males, average ages of 12.52, mean body mass index (BMI) Z-score of 2.27) and their parent/guardian completed surveys assessing QOL and symptoms of OSA syndrome. The subjects also underwent overnight PSG. RESULTS: Overweight patients reported poor QOL. Polysomnographic variables did not correlate with QOL. However, symptoms of OSA as reported on the Pediatric Sleep Questionnaire significantly correlated with QOL from both the parent and the subject. CONCLUSIONS: Overweight youth with symptoms of OSA have a lower QOL both by their report and parental report. Interestingly, objective measures of OSA did not correlate with QOL.