title: Which obese children should have a sleep study?
abstract: BACKGROUND
  The UK government has recommended the development of obesity services for children. As obesity is common, studying every obese child for obstructive sleep apnoea (OSA) would be challenging and full paediatric sleep services are not available in every area in Europe. The purpose of this study was to consider how well clinical features predict significant OSA in obese children in order to help prioritise the need for sleep studies and subsequent treatment.
  
  
  METHODS
  Consecutive children referred for obesity management aged 2-16 years with a body mass index (BMI) of >2.5 z scores for age were offered a sleep study using overnight oximetry and audiovisual recordings. Significant OSA was defined as > or = 5 dips/h of >4% oxygen saturation or > or = 5 respiratory-event related arousals/h.
  
  
  RESULTS
  Forty-one of 158 (26%) children (mean BMI z score 3.7) had significant OSA and 95% of these had either reported apnoea, restless sleep or tonsillar hypertrophy (TH). Nineteen percent of all children had none of these features. BMI was not related to OSA.
  
  
  CONCLUSIONS
  If only obese children with reported apnoea, restless sleep or TH have a sleep study, 95% of all obese children with significant OSA will be identified using this method.
authors.affiliation: 2nd floor, Fielden House, Royal London Hospital, Barts and the London NHS Trust, Whitechapel, London E1 1BB, UK. s.a.mckenzie@awell.co.uk
authors.forename: S A
authors.initials: SA
authors.lastname: McKenzie
authors.forename: A
authors.initials: A
authors.lastname: Bhattacharya
authors.forename: R
authors.initials: R
authors.lastname: Sureshkumar
authors.forename: B
authors.initials: B
authors.lastname: Joshi
authors.forename: A
authors.initials: A
authors.lastname: Franklin
authors.forename: R
authors.initials: R
authors.lastname: Pickering
authors.forename: I
authors.initials: I
authors.lastname: Dundas
mesh_terms: D000234:Adenoids / Q000502:physiology; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D010092:Oximetry / Q000379:methods; D014066:Palatine Tonsil / Q000502:physiology; D018579:Patient Selection; D017286:Polysomnography / Q000379:methods*; D012017:Referral and Consultation; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology