title: Obesity increases the risk for persisting obstructive sleep apnea after treatment in children.
abstract: 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) >or=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 males), 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).
  
  
  CONCLUSIONS
  For children, obesity at the time of diagnosis is a major risk for persisting OSA after treatment, regardless of the severity of initial disease.
authors.affiliation: Division of Pediatric Sleep Medicine and Kosair Children's Hospital Research Institute, Department of Pediatrics, University of Louisville, School of Medicine, 571 S. Preston Street Suite 321, Louisville, KY 40202, USA.
authors.forename: Louise M
authors.initials: LM
authors.lastname: O'Brien
authors.forename: Sinthu
authors.initials: S
authors.lastname: Sitha
authors.forename: Louise A
authors.initials: LA
authors.lastname: Baur
authors.forename: Karen A
authors.initials: KA
authors.lastname: Waters
mesh_terms: D000233:Adenoidectomy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D014068:Tonsillectomy; D017211:Treatment Failure