Obstructive sleep apnea in obese community-dwelling children: the NANOS study.
BACKGROUND
Obesity in children is assumed to serve as a major risk factor in pediatric obstructive sleep apnea syndrome (OSAS). However, the prevalence of OSAS in otherwise healthy obese children from the community is unknown.


OBJECTIVE
To determine the prevalence of OSAS in obese children identified and recruited from primary care centers.


METHODS
A cross-sectional, prospective, multicenter study. Spanish children ages 3-14 y with a body mass index (BMI) greater than or equal to the 95th percentile for age and sex were randomly selected, and underwent medical history, snoring, and Pediatric Sleep Questionnaire (PSQ) assessments, as well as physical examination, nasopharyngoscopy, and nocturnal polysomnography (NPSG) recordings.


RESULTS
Two hundred forty-eight children (54.4% males) with mean age of 10.8 ± 2.6 y were studied with a BMI of 28.0 ± 4.7 kg/m(2) corresponding to 96.8 ± 0.6 percentile when adjusted for age and sex. The mean respiratory disturbance index (RDI), obstructive RDI (ORDI), and obstructive apnea-hypopnea index (OAHI) were 5.58 ± 9.90, 5.06 ± 9.57, and 3.39 ± 8.78/h total sleep time (TST), respectively. Using ≥ 3/h TST as the cutoff for the presence of OSAS, the prevalence of OSAS ranged from 21.5% to 39.5% depending on whether OAHI, ORDI, or RDI were used.


CONCLUSIONS
The prevalence of obstructive sleep apnea syndrome (OSAS) in obese children from the general population is high. Obese children should be screened for the presence of OSAS. ClinicalTrials.gov identifier: NCT01322763.
Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain ; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ; Hospital Universitario de Burgos (HUBU), Burgos, Spain.
María Luz
ML
Alonso-Álvarez
Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain ; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ; Hospital Universitario de Burgos (HUBU), Burgos, Spain.
José Aurelio
JA
Cordero-Guevara
Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain ; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ; Hospital Universitario de Burgos (HUBU), Burgos, Spain.
Joaquin
J
Terán-Santos
Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain ; Hospital Universitario Valdecilla, Santander, Cantabria, Spain.
Mónica
M
Gonzalez-Martinez
Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain ; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ; Hospital Val D'Hebron, Barcelona, Spain.
María José
MJ
Jurado-Luque
Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain ; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ; Hospital San Pedro de Alcantara, Cáceres, Spain.
Jaime
J
Corral-Peñafiel
Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain ; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ; Research Department, Hospital Universitario Araba, BioAraba, Universidad del Pais Vasco, Medicine Department, Vitoria, Spain.
Joaquin
J
Duran-Cantolla
Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
Leila
L
Kheirandish-Gozal
Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
David
D
Gozal
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D010808:Physical Examination; D017286:Polysomnography; D015995:Prevalence; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D012913:Snoring / Q000503:physiopathology; D011795:Surveys and Questionnaires
adenotonsillar hypertrophy; children; obesity; prevalence; sleep apnea