Asthma and obesity as predictors of severe obstructive sleep apnea in an adolescent pediatric population. (26th April 2019)

• Record Type: Journal Article
• Authors: Narayanan, Ajay; Yogesh, Ahana; Mitchell, Ron B.; Johnson, Romaine F.
• Is Part Of: Laryngoscope. Volume 130:Number 3(2020)
• Page Start: 812
• Page End: 817
• Publication Date: 2019-04-26
• Subjects: Severe -- OSA -- asthma -- obesity -- pediatric; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.28029
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objective: To study a cohort of children referred for full‐night polysomnography (PSG) due to suspicion of obstructive sleep apnea (OSA). We examined the relationship between asthma, obesity, and severe OSA (sOSA). Methods: We performed a retrospective case control analysis of children, ages 9 to 17 years, who underwent full‐night PSG. The primary goal was to determine the association between asthma, obesity, and sOSA (apnea‐hypopnea index ≥10). We used multiple logistic regression analysis to estimate these associations after controlling for covariates. A P value of ≤.05 was considered significant. Results: The study included 367 children (mean [standard deviation] age 14 years (1.7), 56% male, 43% Hispanic). The prevalence of asthma was 188 of 367 (52%); obesity was 197 of 367 (54%); and sOSA was 109 of 367 (30%). sOSA was less likely in asthmatics (coefficient = −0.59; standard error [SE] = 0.23; P = .01; odds ratio [OR] = 0.55; 95% confidence interval [CI] = 0.34 to 0.88) and more likely with obesity (coefficient = 0.89; SE = 0.24; P < .001; OR = 2.4; 95% CI = 1.5 to 3.9). The presence of asthma reduced the likelihood of sOSA by an average of 14% among obese patients and 9% among nonobese patients. These associations held even after controlling for age, sex, race, income, and tonsillar hypertrophy. Conclusion: The presence of asthma reduced, whereas obesity increased the likelihood of sOSA among a large cohort of older children referred for PSG. These relationships were additive. Further research is indicated regarding these relationships. Level of Evidence: 3b Laryngoscope, 130:812–817, 2020