title: Differences in the association between obesity and obstructive sleep apnea among children and adolescents.
abstract: OBJECTIVE
  Overweight and obesity are thought to increase the risk of obstructive sleep apnea syndrome (OSAS) among children. However, previous results have been inconsistent and appear to be confounded by both ethnicity and the different ages of children studied. To determine whether the association between excess weight and OSAS varies with age across childhood, we assessed polysomnographic data from a series of Caucasian children and adolescents referred for clinical evaluation of snoring.
  
  
  METHODS
  Sleep and OSAS severity were assessed using polysomnography in 234 children aged 2.0 to 18.0 years. All children were referred for overnight evaluation of suspected OSAS. Severity of OSAS as a function of body mass and age were then evaluated.
  
  
  RESULTS
  Risk of OSAS among adolescents (age > or =12 years) was increased 3.5 fold with each standard-deviation increase in body mass index z-score. Risk of OSAS was not significantly increased with increasing body mass among younger children.
  
  
  CONCLUSIONS
  Similar to adults, adolescent children show an increased risk for having OSAS in association with overweight and obesity. For Caucasian children, overweight and obesity should be considered a significant risk for OSAS among adolescents or from age 12 years, especially when in combination with other established risk factors, including snoring and adenotonsillar hypertrophy.
authors.affiliation: Discipline of Paediatrics, University of Adelaide, Adelaide, Australia. mark.kohler@adelaide.edu.au
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Kohler
authors.forename: Swetlana
authors.initials: S
authors.lastname: Thormaehlen
authors.forename: J Declan
authors.initials: JD
authors.lastname: Kennedy
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Pamula
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: van den Heuvel
authors.forename: Kurt
authors.initials: K
authors.lastname: Lushington
authors.forename: A James
authors.initials: AJ
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D017286:Polysomnography / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*
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