Sarah Selvadurai1, Giorge Voutsas1,2, Colin Massicotte3, Andrea Kassner1,2, Sherri Lynne Katz4,5, Evan J Propst2,6, Indra Narang1,2,3. 1. Translational Medicine, Research Institute, Hospital for Sick Children, Toronto, Canada. 2. University of Toronto, Toronto, Canada. 3. Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Canada. 4. Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada. 5. University of Ottawa, Ottawa, Canada. 6. Department of Otolaryngology, Head and Neck Surgery, Hospital for Sick Children, Toronto, Canada; *Contributed equally.
Abstract
STUDY OBJECTIVES: Positional obstructive sleep apnea (POSA) is a phenotype of obstructive sleep apnea (OSA) where sleep-related obstructive events occur predominantly in the supine position. Limited knowledge exists regarding the presence of POSA in children with obesity. The study objective was to determine the prevalence of POSA while identifying factors associated with POSA in children with obesity. METHODS: This was a cross-sectional study of children with obesity, aged 8 to 18 years, with a diagnostic polysomnogram (PSG) between 2012 to 2019, who were referred for the evaluation of sleep-related breathing. POSA was defined as an overall obstructive apnea-hypopnea index (OAHI) ≥5 events/h and a supine OAHI to nonsupine OAHI ratio of ≥2. Patient demographics, anthropometrics, and PSG data were recorded. RESULTS: Of the 112 children with obesity with a diagnostic PSG, 43 (38%) had OSA. Among those with OSA, 25 of 43 (58%) had POSA (mean age: 14.6 ± 2.3 years; mean body mass index: 37.7 ± 7.6 kg/m²; 68% male) and 18 of 43 (42%) had non-POSA (mean age: 13.9 ± 2.8 years; mean body mass index: 37.9 ± 7.2 kg/m²; 78% male). Among those with POSA, 13 of 25 (52%) had mild OSA, 7 of 25 (28%) had moderate OSA, and 5 of 25 (20%) had severe OSA. No significant differences were found in age, sex, and anthropometric measures between POSA and non-POSA groups. Time spent in supine and nonsupine sleep did not differ significantly between groups. CONCLUSIONS: In children with obesity and OSA, POSA occurs frequently. Identifying POSA allows for potential targeted positional therapy for children with obesity.
STUDY OBJECTIVES:Positional obstructive sleep apnea (POSA) is a phenotype of obstructive sleep apnea (OSA) where sleep-related obstructive events occur predominantly in the supine position. Limited knowledge exists regarding the presence of POSA in children with obesity. The study objective was to determine the prevalence of POSA while identifying factors associated with POSA in children with obesity. METHODS: This was a cross-sectional study of children with obesity, aged 8 to 18 years, with a diagnostic polysomnogram (PSG) between 2012 to 2019, who were referred for the evaluation of sleep-related breathing. POSA was defined as an overall obstructive apnea-hypopnea index (OAHI) ≥5 events/h and a supine OAHI to nonsupine OAHI ratio of ≥2. Patient demographics, anthropometrics, and PSG data were recorded. RESULTS: Of the 112 children with obesity with a diagnostic PSG, 43 (38%) had OSA. Among those with OSA, 25 of 43 (58%) had POSA (mean age: 14.6 ± 2.3 years; mean body mass index: 37.7 ± 7.6 kg/m²; 68% male) and 18 of 43 (42%) had non-POSA (mean age: 13.9 ± 2.8 years; mean body mass index: 37.9 ± 7.2 kg/m²; 78% male). Among those with POSA, 13 of 25 (52%) had mild OSA, 7 of 25 (28%) had moderate OSA, and 5 of 25 (20%) had severe OSA. No significant differences were found in age, sex, and anthropometric measures between POSA and non-POSA groups. Time spent in supine and nonsupine sleep did not differ significantly between groups. CONCLUSIONS: In children with obesity and OSA, POSA occurs frequently. Identifying POSA allows for potential targeted positional therapy for children with obesity.
Authors: F J Nieto; T B Young; B K Lind; E Shahar; J M Samet; S Redline; R B D'Agostino; A B Newman; M D Lebowitz; T G Pickering Journal: JAMA Date: 2000-04-12 Impact factor: 56.272
Authors: Simon A Joosten; Kais Hamza; Scott Sands; Anthony Turton; Philip Berger; Garun Hamilton Journal: Respirology Date: 2012-01 Impact factor: 6.424
Authors: Carole L Marcus; Lee Jay Brooks; Kari A Draper; David Gozal; Ann Carol Halbower; Jacqueline Jones; Michael S Schechter; Stephen Howard Sheldon; Karen Spruyt; Sally Davidson Ward; Christopher Lehmann; Richard N Shiffman Journal: Pediatrics Date: 2012-08-27 Impact factor: 7.124
Authors: Athanasios G Kaditis; Maria Luz Alonso Alvarez; An Boudewyns; Emmanouel I Alexopoulos; Refika Ersu; Koen Joosten; Helena Larramona; Silvia Miano; Indra Narang; Ha Trang; Marina Tsaoussoglou; Nele Vandenbussche; Maria Pia Villa; Dick Van Waardenburg; Silke Weber; Stijn Verhulst Journal: Eur Respir J Date: 2015-11-05 Impact factor: 16.671