Over-Weight Obesity and Sleep Apnea

Obstructive sleep apnea (OSA) is more common among obese children than children with normal weight. Children with Over-Weight Obesity have 25-45% chances of having Obstructive sleep apnea (OSA) as compared with 1-3% in normal weight children.

Why children with Over-Weight Obesity are more predisposed to have Obstructive sleep apnea (OSA)?

In obese children, the cause of obstruction is multifactorial.
The important cause are:

  • Enlarged tonsil and adenoid tissue
  • Deposition of fat tissue around the neck airway called as pharynx makes it narrow
  • External compression from the subcutaneous tissues of the neck

When do we suspect Obstructive sleep apnea (OSA) in children with Obesity?

Obstructive sleep apnea (OSA) is usually suspected when children are having persistent snoring, difficulty in sleeping associated with frequent awakenings, sleeping in abnormal postures, excessive sleepiness during day, morning headaches and poor scholastic performance.

How do we diagnose Obstructive sleep apnea (OSA) in children with Obesity?

Children with Over-Weight Obesity who are suspected to have Obstructive sleep apnea (OSA) need to undergo a sleep study or polysomnography.

What are the consequences of Obstructive sleep apnea (OSA) in children with Obesity?

Children with Over-Weight Obesity and Obstructive sleep apnea (OSA) can have serious consequences for neurocognitive function like hyperactivity and inattention, behaviour problems and poor school performance.

What are the long term consequences of children with Over-Weight Obesity?

Children with overweight and obesity are more likely to become obese adults and are at increased risk for other health conditions including diabetes, cardiovascular disease, hypertension in addition to obstructive sleep apnea (OSA).

How do we treat Obstructive sleep apnea (OSA) in children with Obesity?

Tonsillectomy and adenoidectomy is the treatment of choice for Obstructive sleep apnea (OSA). Removing the obstructive adenoids and tonsils increases the patency of the oral airway, improving OSA in most children. Since, the cause of OSA is multifactorial most obese children do not have complete resolution of OSA after tonsillectomy and adenoidectomy. Repeat sleep study is required after surgery and residual OSA is treated with CPAP or Continuous Positive Airway Pressure.