TABLE 19

Risk of SDB Conferred by Overweight and Obesity

SourceLevelType of StudyNo.DurationDiagnostic TechniqueOther FeaturesFindingsP for Obesity as a Risk Factor
Urschitz et al164IICommunity-based sample of third graders11441 yParental report of snoring, BMI, SES, risk factors for rhinitis, asthmaHabitual snorers reassessed at 1 y, with 49% continuing to snoreBMI ≥90% conferred a 4 times higher risk of HS versus a BMI <75%; 25% of obese subjects had HS
Corbo et al166IICommunity-based sample of 10- to 15-y-old children from 10 schools24392 yParental questionnaire and nasal examination and BMI by physicianSnoring increased significantly with BMI >90% and was >2 times for BMI >95% vs <75%.000
Shin et al47IVCross-sectional community-based sample of high school students3871NAQuestionnaire (tested for reliability) completed by subject, caretakers, and sleep partnerKorean children; 81% response rate to surveySnoring frequency was significantly associated with increasing BMI<.001
Bidad et al167IICross-sectional study of 11- to 17-y-old children3300NAScripted face-to-face interview and measurements of BMI and tonsil size by physician7.9% of sample with HS (≥3 nights per week when well)>Twofold risk of snoring in overweight or obesity
Stepanski et al168IIICase series;190NAClinical interview, PSG68% with SDB (≥5 AHI, <90% Spo2, sleep fragmentation, ECG changes)BMI was higher in the SDB group <.01
mean age: 5.9 ± 3.7 y
Rudnick et al169IIICompared children scheduled for AT with control group from same urban setting170 SDBNABMI, ethnicityAfrican American children who had SDB were more likely to be obese than African American children who did not have SDB<.02
129 controls
Li et al12IICross-sectional study of 13 primary schools6447 by questionnaireNAQuestionnaire in all with PSG and examination in high-risk group and low-risk subset for comparisonHong Kong 9172 sampled with 70% response rateMale gender, BMI, and AT size were independently associated with OSA
410 high risk and 209 low risk with exam and PSG
Li et al172IICross-sectional study of 13 primary schools; same population as previous study6349NAQuestionnaireDesigned to determine prevalence of HS and associated symptoms.Prevalence of HS was 7.2%; male gender, BMI, parental HS, nasal allergies, asthma were associated with snoring<.0001
Brunetti et al23IICross-sectional; mean age 7.3 y1207 screened, 809 eligibleNAQuestionnaire in all followed by oximetry in the 44 who had HS; PSG in subset who had abnormal oximetry resultsSouthern ItalyHS more common in the obese group; no difference in OSA by PSG across weight groups.02
Bixler et al11IICross-sectional study of grades K–55740 had questionnaireNAQuestionnaire followed by PSG in subsetPrevalence of AHI >5 1.2%. Strong linear relationship between waist circumference and BMI with SDBWaist circumference associated with all levels of SDB, also nasal complaints and minority race
700 randomly selected for PSG, 490 completed
Urschitz et al165IIICross-sectional community-based of primary schoolchildren995NAOvernight oximetryOverweight, smoke exposure, respiratory allergies were independent risk factors for sleep hypoxemia
  • AT, adenotonsillar; K, kindergarten; NA, not available; OSA, obstructive sleep apnea.