title: Treatment outcomes of obstructive sleep apnoea in obese community-dwelling children: the NANOS study.
abstract: The first line of treatment of obstructive sleep apnoea syndrome (OSAS) in children consists of adenotonsillectomy (T&A). The aim of the present study was to evaluate treatment outcomes of OSAS among obese children recruited from the community.A cross-sectional, prospective, multicentre study of Spanish obese children aged 3-14 years, with four groups available for follow-up: group 1: non-OSAS with no treatment; group 2: dietary treatment; group 3: surgical treatment; and group 4: continuous positive airway pressure treatment.117 obese children (60 boys, 57 girls) with a mean age of 11.3±2.9 years completed the initial (T0) and follow-up (T1) assessments. Their mean body mass index (BMI) at T1 was 27.6±4.7 kg·m(-2), corresponding to a BMI Z-score of 1.34±0.59. Mean respiratory disturbance index (RDI) at follow-up was 3.3±3.9 events·h(-1). Among group 1 children, 21.2% had an RDI ≥3 events·h(-1) at T1, the latter being present in 50% of group 2, and 43.5% in group 3. In the binary logistic regression model, age emerged as a significant risk factor for residual OSAS (odds ratio 1.49, 95% confidence interval 1.01-2.23; p<0.05) in obese children surgically treated, and RDI at T0 as well as an increase in BMI emerged as significant risk factors for persistent OSAS in obese children with dietary treatment (OR 1.82, 95% CI 1.09-3.02 (p<0.03) and OR 8.71, 95% CI 1.24-61.17 (p=0.03)).Age, RDI at diagnosis and obesity are risk factors for relatively unfavourable OSAS treatment outcomes at follow-up.
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain CIBER of Respiratory Diseases, Instituto Carlos III, CIBERES, Spain Hospital Universitario de Burgos (HUBU), Burgos, Spain mlalonso@hubu.es.
authors.forename: María Luz
authors.initials: ML
authors.lastname: Alonso-Álvarez
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain CIBER of Respiratory Diseases, Instituto Carlos III, CIBERES, Spain Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Terán-Santos
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Navazo-Egüia
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain Hospital Universitario Valdecilla, Santander, Spain.
authors.forename: Mónica Gonzalez
authors.initials: MG
authors.lastname: Martinez
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain CIBER of Respiratory Diseases, Instituto Carlos III, CIBERES, Spain Hospital Val D´Hebron, Barcelona, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Jurado-Luque
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain CIBER of Respiratory Diseases, Instituto Carlos III, CIBERES, Spain Hospital San Pedro de Alcantara, Caceres, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Corral-Peñafiel
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain CIBER of Respiratory Diseases, Instituto Carlos III, CIBERES, Spain Hospital Universitario de Araba, Vitoria, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Duran-Cantolla
authors.affiliation: Sleep Unit, Hospital Universitario de Burgos, Burgos, Spain Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors.forename: José Aurelio
authors.initials: JA
authors.lastname: Cordero-Guevara
authors.affiliation: Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.affiliation: Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D000233:Adenoidectomy / Q000379:methods; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D017286:Polysomnography / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D013030:Spain; D014068:Tonsillectomy / Q000379:methods; D016896:Treatment Outcome