Obstructive Sleep Apnea in Overweight and Obese Children: Factors Influencing Quality of Life

Abstract

Introduction: There is a paucity of data regarding biological sex influence and the impact of obstructive sleep apnea (OSA) on the quality of life (QoL) of obese children with OSA. Thus, we aimed to assess the influence of biological sex on polysomnography (PSG) and evaluate the impact of OSA on obese children's QoL.

Methods: Records of overweight or obese pediatric patients referred for sleep studies at the Jordan University Hospital between 2018 and 2022 were retrospectively reviewed. Children underwent PSG and anthropometric measurements. OSA diagnosis and severity were determined per the Apnea-Hypopnea Index (AHI). QoL was determined by the OSA-18 tool.

Results: Across a sample of 136 children, biological sex did not influence PSG indices, but there were significant differences across the sleep disorder (p = 0.023) and daily functioning (p = 0.007) QoL domains. Age affected the non-REM sleep percentages and NADIR of O2 saturation (all p < 0.01). There were significant differences across the emotional distress and daytime function domains across age groups (all p < 0.05). Body mass index (BMI) did not significantly influence AHI strata, but was associated with worse daytime function (p < 0.05). Additionally, OSA severity was associated with poorer sleep disorder and concerns about caregivers' scores (all p < 0.05). On multivariate analysis, gender predicted OSA-18 total score, but not age, BMI, or AHI.

Conclusion: It appears that biological sex has no clinical impact on OSA among obese children. However, it appears that age significantly influences both OSA and its associated QoL.

Keywords: biological sex; obesity; obstructive sleep apnea; polysomnography; quality of life; sleep‐disordered breathing.

FIGURE 1

Comparison of total OSA‐18 scores across gender, age groups, and AHI. Severity levels. (A) Differences in total OSA‐18 score among genders (male vs. female; mean difference (MD): 10.6; p‐value: 0.0414). (B) Differences in total OSA‐18 score among age groups (< 6 vs. 6–12; MD: 11.7; p‐value: 0.034), (< 6 vs. > 12; MD: 6.4; p‐value: 0.296). (C) Differences in total OSA‐18 score among AHI strata (mild vs. moderate; MD: 5.1; p‐value: 0.401), (mild vs. severe; MD: 11.9; p‐value: 0.018).