- Design
- Retrospective cohort
- Population
- 461 children with OSA in a paediatric ENT clinic (42% obese)
- Primary outcome
- Polysomnographic sleep architecture by obesity class
- Effect
- Class III obesity: total sleep −38.1 min (−58.8 to −17.4); efficiency −5.7% (−9.5 to −1.8); REM −3.1% (−5.1 to −1.1)
This retrospective review of 461 children with obstructive sleep apnoea seen in a paediatric ENT clinic (42% obese) examined how obesity class related to polysomnographic sleep architecture.
Compared with healthy-weight children, those with class II and III obesity had shorter total sleep time (about 28 and 38 minutes less) and lower sleep efficiency, with more wakefulness after sleep onset. REM sleep was reduced in class I and III obesity. After adjustment, BMI category was independently associated with total sleep time, efficiency, deep sleep and REM, while OSA severity was associated mainly with light N1 sleep.
For clinicians, obesity in a child with OSA is not only a risk factor for residual disease after adenotonsillectomy; it is linked to disrupted sleep in its own right. Weight management belongs in the plan alongside surgery. Childhood obesity is rising quickly in urban India.
- Measure BMI centile in every child referred with snoring or suspected OSA.
- Counsel families of obese children that adenotonsillectomy may not fully restore sleep quality.
- Include weight management and dietetic referral in the OSA plan for children with obesity.
- Arrange post-operative sleep study in obese children, who more often have residual OSA.
Why it matters
It suggests weight, not only airway obstruction, is linked to poor sleep in obese children with OSA.
Don't overread it
Retrospective and cross-sectional; it shows association between obesity and sleep architecture, not that weight loss restores sleep.
The statistics, in plain English
β values here are adjusted differences from healthy-weight children: −38 minutes of total sleep in class III obesity means they slept about 38 minutes less on the study night, after accounting for other factors.
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