Sleep associated gas exchange abnormalities in children and adolescents with habitual snoring

• Published in: Pediatric pulmonology Vol. 44; no. 4; pp. 364 - 372
• Main Authors: Carno, Margaret-Ann, Modrak, Joseph, Short, Renee, Ellis, Ethan R., Connolly, Heidi V.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.04.2009; Wiley-Liss
• Subjects: Adolescent; adolescents; Biological and medical sciences; Body Mass Index; Body Weight; Child; Child, Preschool; children; Comorbidity; Female; General aspects; Humans; Hypercapnia - epidemiology; Male; Medical sciences; Metabolic diseases; Obesity; Obesity - epidemiology; obstructive hypoventilation; OSAS; overweight; Pneumology; Polysomnography; Prevalence; Pulmonary Gas Exchange; Retrospective Studies; Severity of Illness Index; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Snoring - diagnosis; Snoring - epidemiology; Human; Obesity; Pediatrics; obstructive hypoventilation; adolescents; Nutrition disorder; Obstruction; Snoring; Overweight; Sleep; OSAS; children; Adolescent; Anomaly; Gas exchange; Child; Nutritional status; Pneumology
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.21012

Study Objectives The purpose of this study was to describe the prevalence of polysomnographically diagnosed OSAS and to describe the severity of sleep associated gas exchange abnormalities (SAGEA) in habitually snoring children. We hypothesized that there would be a high prevalence of OSAS in obese children with habitual snoring and that the most overweight children would have the most significant SAGEA. Design Retrospective chart review. Measurements and Results Nocturnal polysomnography (NPSG) data from 114 children and adolescents referred for habitual snoring were examined. 74 of the subjects were male (65%), average age of 9.78 ± 4.19 years, average AHI 13.51 ± 20.25, mean BMI z‐score 1.79 ± 1.18. BMI z‐scores correlated positively with severity of OSAS (P < 0.05) such that children with progressive degrees of obesity had more frequent respiratory events during sleep. Additionally, severity of sleeping hypercapnea as measured by percent of total sleep time with EtCO2 values above 50 mm Hg was more severe with progressive degrees of obesity. Likewise, all measures of oxyhemoglobin desaturation were more severe with progressive degrees of obesity. Positive correlations between the severity of SAGEA and degree of obesity remained even after controlling for the severity of OSAS. Conclusions OSAS is highly prevalent in children referred to a pediatric sleep center with complaints of habitual snoring across a wide spectrum of weight categories. SAGEA increases with progressive obesity even when controlling for the severity of OSAS suggesting that obesity is an independent risk factor for SAGEA. Furthermore, because obese children frequently have SAGEA, capnography should be obtained during NPSG when possible. Pediatr Pulmonol. 2009; 44:364–372. © 2009 Wiley‐Liss, Inc.