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New study in JCSM finds that obesity can predict upper airway obstruction amongst children

WESTCHESTER, Ill. In Australian children who snore, obesity, not age, is a significant, but only weak, predictor of upper airway obstruction during sleep, according to a study published in the April 15 issue of the Journal of Clinical Sleep Medicine (JCSM).

The study, authored by Mark Kohler and colleagues at the University of Adelaide, focused on 190 children between four and 12 years of age, who were referred for evaluation of upper airway obstruction and underwent one night of polysomnography, or a sleep test that monitors the brain, eye movements, muscle activity, heart rhythm, and breathing. The children were classified as Infrequent Snorers, Habitual Snorers or with Obstructive Sleep Apnea Syndrome (OSAS).

According to the results, the association between body mass and upper airway obstruction severity was not significantly influenced by age; however, the contribution of body mass to upper airway obstruction amongst Caucasian children was much milder than typically found amongst African-American children, and similar to Asian children. Another important finding was that, although more frequently reported amongst younger children, the incidence of central apneas during sleep was also associated with increasing body weight.

There has been a dramatic rise in the incidence of childhood obesity during the last decade, which, in addition to a range of other health concerns, may be placing greater numbers of children at risk of OSAS, said Kohler. A careful inspection of the previous literature suggests factors that may not have been considered in analyses, such as age and ethnicity of a child, are important determinants of the strength of the relationship between body mass and upper airway obstruction during sleep. These findings suggest that, while the increasing rate of obesity amongst children is alarming, it may be a more critical determinant of upper airway obstruction amongst certain races only. In addition, central respiratory events are important to consider amongst overweight children under evaluation for suspected upper airway obstruction.

In any case, obesity can still increase an individual childs risk for developing OSA, a sleep-related breathing disorder that causes your body to stop breathing during sleep. OSA, which can disturb your sleep numerous times on any given night, can result in poor daytime function including excessive sleepiness, as well as an increased risk of stroke, diabetes and heart disease. OSA is a serious sleep disorder that can be harmful, or even fatal, if left untreated.

OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs. OSA occurs in about two percent of young children. It can develop in children at any age, but it is most common in pre-schoolers. OSA often occurs between the ages of three and six years when the tonsils and adenoids are large compared to the throat. OSA appears to occur at the same rate in young boys and girls. OSA also is common in children who are obese, and is more likely to occur in a child who has a family member with OSA.

It is recommended that school-aged children get between 10-11 hours of nightly sleep and children in pre-school between 11-13 hours.

The American Academy of Sleep Medicine (AASM) offers some tips to help your child sleep better:

  • Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your child ready to go to sleep each night.

  • Establish a relaxing setting at bedtime.

  • Interact with your child at bedtime. Dont let the TV, computer or video games take your place.

  • Keep your children from TV programs, movies, and video games that are not right for their age.

  • Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.

  • At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas. Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.

It is important to make sure that your child gets enough sleep and sleeps well. The value of sleep can be measured by your childs smiling face, happy nature and natural energy. A tired child may have development or behavior problems. A childs sleep problems can also cause unnecessary stress for you and the other members of your family.


Contact: Jim Arcuri
American Academy of Sleep Medicine

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