Asthma and obesity as predictors of severe obstructive sleep apnea in an adolescent pediatric population

Ajay Narayanan, Ahana Yogesh, Ron B Mitchell, Romaine F Johnson

Research output: Contribution to journalArticle

Abstract

Objective: To study a cohort of children referred for full-night polysomnography (PSG) due to suspicion of obstructive sleep apnea (OSA). We examined the relationship between asthma, obesity, and severe OSA (sOSA). Methods: We performed a retrospective case control analysis of children, ages 9 to 17 years, who underwent full-night PSG. The primary goal was to determine the association between asthma, obesity, and sOSA (apnea-hypopnea index ≥10). We used multiple logistic regression analysis to estimate these associations after controlling for covariates. A P value of ≤.05 was considered significant. Results: The study included 367 children (mean [standard deviation] age 14 years (1.7), 56% male, 43% Hispanic). The prevalence of asthma was 188 of 367 (52%); obesity was 197 of 367 (54%); and sOSA was 109 of 367 (30%). sOSA was less likely in asthmatics (coefficient = −0.59; standard error [SE] = 0.23; P =.01; odds ratio [OR] = 0.55; 95% confidence interval [CI] = 0.34 to 0.88) and more likely with obesity (coefficient = 0.89; SE = 0.24; P <.001; OR = 2.4; 95% CI = 1.5 to 3.9). The presence of asthma reduced the likelihood of sOSA by an average of 14% among obese patients and 9% among nonobese patients. These associations held even after controlling for age, sex, race, income, and tonsillar hypertrophy. Conclusion: The presence of asthma reduced, whereas obesity increased the likelihood of sOSA among a large cohort of older children referred for PSG. These relationships were additive. Further research is indicated regarding these relationships. Level of Evidence: 3b Laryngoscope, 2019.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StatePublished - Jan 1 2019

Fingerprint

Obstructive Sleep Apnea
Asthma
Obesity
Polysomnography
Pediatrics
Morbid Obesity
Population
Odds Ratio
Confidence Intervals
Laryngoscopes
Apnea
Hispanic Americans
Hypertrophy
Cohort Studies
Logistic Models
Regression Analysis
Research

Keywords

  • asthma
  • obesity
  • OSA
  • pediatric
  • Severe

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Asthma and obesity as predictors of severe obstructive sleep apnea in an adolescent pediatric population. / Narayanan, Ajay; Yogesh, Ahana; Mitchell, Ron B; Johnson, Romaine F.

In: Laryngoscope, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Objective: To study a cohort of children referred for full-night polysomnography (PSG) due to suspicion of obstructive sleep apnea (OSA). We examined the relationship between asthma, obesity, and severe OSA (sOSA). Methods: We performed a retrospective case control analysis of children, ages 9 to 17 years, who underwent full-night PSG. The primary goal was to determine the association between asthma, obesity, and sOSA (apnea-hypopnea index ≥10). We used multiple logistic regression analysis to estimate these associations after controlling for covariates. A P value of ≤.05 was considered significant. Results: The study included 367 children (mean [standard deviation] age 14 years (1.7), 56{\%} male, 43{\%} Hispanic). The prevalence of asthma was 188 of 367 (52{\%}); obesity was 197 of 367 (54{\%}); and sOSA was 109 of 367 (30{\%}). sOSA was less likely in asthmatics (coefficient = −0.59; standard error [SE] = 0.23; P =.01; odds ratio [OR] = 0.55; 95{\%} confidence interval [CI] = 0.34 to 0.88) and more likely with obesity (coefficient = 0.89; SE = 0.24; P <.001; OR = 2.4; 95{\%} CI = 1.5 to 3.9). The presence of asthma reduced the likelihood of sOSA by an average of 14{\%} among obese patients and 9{\%} among nonobese patients. These associations held even after controlling for age, sex, race, income, and tonsillar hypertrophy. Conclusion: The presence of asthma reduced, whereas obesity increased the likelihood of sOSA among a large cohort of older children referred for PSG. These relationships were additive. Further research is indicated regarding these relationships. Level of Evidence: 3b Laryngoscope, 2019.",
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