Ajay Narayanan1, Ahana Yogesh1, Ron B Mitchell1,2, Romaine F Johnson1,2. 1. Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A. 2. Division of Pediatric Otolaryngology, Children's Medical Center, Dallas, Texas, U.S.A.
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.
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 obesepatients 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.
Authors: Bronwyn K Brew; Emma Caffrey Osvald; Tong Gong; Anna M Hedman; Kirsten Holmberg; Henrik Larsson; Jonas F Ludvigsson; Mwenya Mubanga; Awad I Smew; Catarina Almqvist Journal: Clin Exp Allergy Date: 2022-07-28 Impact factor: 5.401