Published online December 29, 2008
PEDIATRICS Vol. 123 No. 1 January 2009, pp. 13-18 (doi:10.1542/10.1542/peds.2008-0228)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gozal, D.
Right arrow Articles by Kheirandish-Gozal, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gozal, D.
Right arrow Articles by Kheirandish-Gozal, L.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Obesity and Excessive Daytime Sleepiness in Prepubertal Children With Obstructive Sleep Apnea

David Gozal, MD and Leila Kheirandish-Gozal, MD

Kosair Children's Hospital Research Institute and Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, Louisville, Kentucky

INTRODUCTION. The epidemic of childhood obesity has prompted remarkable changes in the relative proportions of symptomatic overweight or obese children being referred for evaluation of habitual snoring. However, it remains unclear whether obesity modifies the relative frequency of daytime symptoms such as excessive daytime sleepiness.

METHODS. Fifty consecutive, nonobese, habitually snoring, otherwise-healthy children (age range: 6–9 years) and 50 age-, gender-, and ethnicity-matched obese children (BMI z score: >1.67) underwent an overnight polysomnographic evaluation, followed by a multiple sleep latency test the following day.

RESULTS. The mean obstructive apnea/hypopnea index values for the 2 groups were similar (nonobese: 12.0 ± 1.7 episodes per hour of total sleep time; obese: 10.9 ± 1.5 episodes per hour of total sleep time). However, the mean sleep latency for obese children was significantly shorter (12.9 ± 0.9 minutes) than that for nonobese children (17.9 ± 0.7 minutes). Furthermore, 21 obese children had mean sleep latencies of ≤12.0 minutes, compared with only 5 nonobese children. Although significant associations emerged between mean sleep latency, obstructive apnea/hypopnea index, proportion of total sleep time with oxygen saturation of <95%, and respiratory arousal index for the whole cohort, the slopes and intersects of the linear correlation of mean sleep latency with any of these polygraphic measures were consistently greater in the obese cohort.

CONCLUSIONS. The likelihood of excessive daytime sleepiness for obese children is greater than that for nonobese children at any given level of obstructive sleep apnea severity and is strikingly reminiscent of excessive daytime sleepiness patterns in adults with obstructive sleep apnea.

Key Words: excessive daytime sleepiness • obesity • hypoxia • sleep apnea • sleep fragmentation

Abbreviations: EDS—excessive daytime sleepiness • MSL—mean sleep latency • TST—total sleep time • OSA—obstructive sleep apnea • OAHI—obstructive apnea/hypopnea index • RAI—respiratory arousal index • SaO2—arterial oxygen saturation

Accepted Mar 24, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?