title: Central sleep apnea in obese children with sleep-disordered breathing.
abstract: OBJECTIVE
  In contrast to obstructive sleep apnea (OSA), central sleep apnea (CSA) in obese children has received lesser attention. As pediatric CSA is more prevalent than expected and adversely impacts health, this study aims to elucidate the major factors associated with central apnea index (CAI) and compare CSA between obese and non-obese children.
  
  
  METHODS
  Retrospective analysis was performed in a tertiary referral medical center. Children with sleep-disordered breathing (SDB) ranging from 2-18 years old were enrolled. All participants completed history taking, otolaryngological examination and overnight polysomnography. CSA was defined as having CAI exceeding 1 h(-1). CAI and the prevalence of CSA were analyzed in children of different age groups, weight statuses and adenotonsillar sizes.
  
  
  RESULTS
  A total of 487 cases were included. The prevalence of CSA was 13.3% (65/487). CAI was negatively correlated with age (r=-0.32, P<0.001). Obese children had a significantly lower CAI than that of non-obese ones (0.20 ± 0.36 vs 0.48 ± 0.82 h(-1), P<0.001). Multiple linear regression analysis demonstrated a relationship between CAI, age and obesity as 'CAI=0.883-0.055 × Age -0.22 × (Obesity)'.
  
  
  CONCLUSIONS
  In children with SDB, younger ones have a significantly higher CAI than older ones. Additionally, obese children had a lower CAI than non-obese ones.
authors.affiliation: 1] Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan [2] Department of Otolaryngology, National Taiwan University Hospital Yun-Lin branch, Yunlin County, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Chou
authors.affiliation: 1] Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan [2] Department of Otolaryngology, Taipei Hospital, Department of Health, New Taipei City, Taiwan [3] Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: K T
authors.initials: KT
authors.lastname: Kang
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: W C
authors.initials: WC
authors.lastname: Weng
authors.affiliation: 1] Sleep center, National Taiwan University Hospital, Taipei, Taiwan [2] Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: P L
authors.initials: PL
authors.lastname: Lee
authors.affiliation: 1] Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan [2] Sleep center, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: W C
authors.initials: WC
authors.lastname: Hsu
mesh_terms: D000234:Adenoids / Q000473:pathology*; D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology*; D063766:Pediatric Obesity / Q000150:complications / Q000503:physiopathology* / Q000517:prevention & control; D017286:Polysomnography; D015995:Prevalence; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications*; D020182:Sleep Apnea, Central / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D014068:Tonsillectomy
references.citation: Chest. 2005 Feb;127(2):543-9
references.pmid: 15705994
references.citation: Arch Dis Child. 2007 Mar;92(3):205-8
references.pmid: 17041010
references.citation: Br J Nutr. 2009 Apr;101(8):1262-6
references.pmid: 18755049
references.citation: Cardiovasc Diabetol. 2009 Jun 03;8:30
references.pmid: 19490650
references.citation: Clin Chem Lab Med. 2010 May;48(5):707-11
references.pmid: 20450333
references.citation: Am Rev Respir Dis. 1978 Nov;118(5):909-39
references.pmid: 216294
references.citation: Am J Respir Crit Care Med. 1996 Feb;153(2):866-78
references.pmid: 8564147
references.citation: Sleep. 2004 Nov 1;27(7):1337-43
references.pmid: 15586786
references.citation: Am J Orthod Dentofacial Orthop. 2006 Dec;130(6):700-8
references.pmid: 17169731
references.citation: Hypertension. 2005 Dec;46(6):1327-32
references.pmid: 16286569
references.citation: Int J Pediatr Otorhinolaryngol. 1987 Aug;13(2):149-56
references.pmid: 3667094
references.citation: J Sleep Res. 2009 Dec;18(4):415-21
references.pmid: 19732317
references.citation: Respir Med. 2001 Aug;95(8):693-6
references.pmid: 11530959
references.citation: Sleep Breath. 2010 Dec;14(4):381-6
references.pmid: 20495963
references.citation: Otolaryngol Head Neck Surg. 2012 Mar;146(3):487-90
references.pmid: 22075072
references.citation: Sleep Med. 2009 Oct;10(9):1005-11
references.pmid: 19464948
references.citation: Brain Res. 1997 Dec 5;778(1):127-34
references.pmid: 9462884
references.citation: Int J Obes (Lond). 2013 Apr;37(4):527-31
references.pmid: 23183325
references.citation: Chest. 2007 Feb;131(2):595-607
references.pmid: 17296668
references.citation: Int J Pediatr Otorhinolaryngol. 2009 Jul;73(7):1025-8
references.pmid: 19410303
references.citation: West J Med. 1978 Jun;128(6):477-81
references.pmid: 664649
references.citation: Sleep Breath. 2007 Jun;11(2):117-24
references.pmid: 17187265
references.citation: Am J Respir Crit Care Med. 1995 Aug;152(2):473-9
references.pmid: 7633695
references.citation: BMJ. 2000 May 6;320(7244):1240-3
references.pmid: 10797032
references.citation: Chest. 2004 Mar;125(3):872-8
references.pmid: 15006944
references.citation: J Clin Endocrinol Metab. 2000 Mar;85(3):1151-8
references.pmid: 10720054
references.citation: Chest. 2008 Mar;133(3):684-9
references.pmid: 18198258
references.citation: Pediatr Pulmonol. 2011 Oct;46(10):1023-30
references.pmid: 21520440
references.citation: Am J Respir Crit Care Med. 1999 May;159(5 Pt 1):1477-84
references.pmid: 10228114
references.citation: Respir Physiol Neurobiol. 2012 May 31;181(3):321-5
references.pmid: 22484378
references.citation: Pediatrics. 2003 Mar;111(3):554-63
references.pmid: 12612236
references.citation: Pediatrics. 2006 Mar;117(3):741-53
references.pmid: 16510654
references.citation: Chest. 2001 Dec;120(6):1930-5
references.pmid: 11742924
references.citation: Pediatr Pulmonol. 2005 Jul;40(1):22-30
references.pmid: 15858805
references.citation: Pediatr Pulmonol. 2007 Feb;42(2):159-67
references.pmid: 17186545
references.citation: J Cardiol. 2012 Aug;60(2):78-85
references.pmid: 22824295
references.citation: J Appl Physiol (1985). 1996 May;80(5):1528-39
references.pmid: 8727536
references.citation: AJR Am J Roentgenol. 1979 Sep;133(3):401-4
references.pmid: 111497
references.citation: Sleep. 2010 Oct;33(10):1333-9
references.pmid: 21061855
references.citation: Thorax. 2002 Jan;57(1):75-6
references.pmid: 11809994
references.citation: Proc Am Thorac Soc. 2008 Feb 15;5(2):242-52
references.pmid: 18250218
references.citation: Exp Physiol. 2005 Jan;90(1):13-24
references.pmid: 15572458
references.citation: Diabetes Res Clin Pract. 2007 May;76(2):245-50
references.pmid: 17118479
references.citation: Thorax. 2009 Aug;64(8):719-25
references.pmid: 19386586
references.citation: Chest. 2002 Sep;122(3):829-39
references.pmid: 12226021
references.citation: N Engl J Med. 1996 Feb 1;334(5):292-5
references.pmid: 8532024
references.citation: Am Rev Respir Dis. 1992 Nov;146(5 Pt 1):1235-9
references.pmid: 1443877
references.citation: Am J Respir Crit Care Med. 2003 Dec 15;168(12):1540
references.pmid: 14668259
references.citation: J Formos Med Assoc. 2014 Jul;113(7):454-62
references.pmid: 24961188