Obesity increases the risk for persisting obstructive sleep apnea after treatment in children

Objective: To evaluate the impact of obesity at diagnosis on treatment outcomes in paediatric obstructive sleep apnea (OSA). Methods: Children were included if they had both diagnostic and follow-up studies for OSA. Anthropological and polysomnographic data were collected at the time of both studies. Polysomnograms were scored using standard criteria and OSA was defined as a respiratory disturbance index (RDI) >= 5. Obesity was defined as a body mass index standard deviation (z-)score (BMIsds) greater than 2, adjusted for age and gender. Results: For 69 children (49 mates), mean age was 7.1 +/- 4.2 years and 29 (42%) children were obese. There was no significant difference in RDI between obese and non-obese children at diagnostic study. Following adenotonsillectomy the obese children had a significantly higher mean RDI (10.7 +/- 15.6 versus 3.7 +/- 4.3; p = 0.01). Disease resolution occurred in 77.5% of non-obese compared to 45% of obese children (p = 0.011). The odds ratio (OR) for persistent OSA in obese compared to non-obese children was 4.2 (95% CI: 1.5-11.9; p = 0.005). Using initial RDI as a covariate, these data show that obesity in children has an adjusted OR for persistent OSA after adenotonsillectomy 3.7 (95% CI: 1.3-10.8, p = 0.016). Conclusion: For children, obesity at the time of diagnosis is a major risk for persisting OSA after treatment, regardless of the severity of initial disease. (C) 2006 Published by Elsevier Ireland Ltd.