Quality of life in children and adolescents with overweight or obesity: Impact of obstructive sleep apnea

Kathrine Nordblad Fenger; Ida Gillberg Andersen; Louise Aas Holm; Jens-Christian Holm; Preben Homøe

doi:10.1016/j.ijporl.2020.110320

Quality of life in children and adolescents with overweight or obesity: Impact of obstructive sleep apnea

Int J Pediatr Otorhinolaryngol. 2020 Nov:138:110320. doi: 10.1016/j.ijporl.2020.110320. Epub 2020 Aug 18.

Authors

Kathrine Nordblad Fenger¹, Ida Gillberg Andersen², Louise Aas Holm³, Jens-Christian Holm⁴, Preben Homøe⁵

Affiliations

¹ Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Lykkebækvej 1, 4600 Køge, Denmark. Electronic address: kathrinefenger@hotmail.com.
² Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Lykkebækvej 1, 4600 Køge, Denmark; The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark. Electronic address: ida_ga@hotmail.com.
³ The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark. Electronic address: loani@regionsjaelland.dk.
⁴ The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3A, 2200 Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark. Electronic address: jhom@regionsjaelland.dk.
⁵ Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Lykkebækvej 1, 4600 Køge, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark. Electronic address: prho@regionsjaelland.dk.

PMID: 32889438
DOI: 10.1016/j.ijporl.2020.110320

Abstract

Objectives: To investigate the association between obstructive sleep apnea (OSA) and health related quality of life (HRQOL) in children and adolescents referred to an obesity treatment clinic. In addition, we examined the association between body mass index standard deviation score (BMI SDS) and HRQOL comparing children and adolescents with overweight or obesity without OSA with a control group of children and adolescents with normal weight without OSA.

Methods: This cross-sectional study included 130 children and adolescents with overweight or obesity (BMI SDS > 1.28) aged 7-18 years recruited from an obesity treatment clinic. The control group consisted of 28 children and adolescents with normal weight (BMI SDS ≤ 1.28) aged 7-18 years recruited from schools. Sleep examinations were performed using a type 3 portable sleep monitor, Nox T3. OSA was defined as apnea-hypopnea index (AHI) ≥ 2. HRQOL was measured by the Pediatric Quality of Life Inventory (PedsQL) 4.0 generic core scale.

Results: A total of 56 children and adolescents with overweight or obesity were diagnosed with OSA (43%). The children and adolescents with OSA were older (p = 0.01) and had higher BMI SDS (p = 0.04) than children and adolescents without OSA. In generalized linear regression analyses adjusted for age, sex, BMI SDS and pubertal development stage there was no association between OSA or AHI and HRQOL in children and adolescents with overweight or obesity. In the analysis, including children and adolescents without OSA and the normal-weight control group, the generalized linear regression adjusted for age, sex and AHI revealed an association between BMI SDS and HRQOL (p < 0.001).

Conclusion: We found no association between AHI or OSA and HRQOL in children and adolescents with overweight or obesity. However, we found an association between BMI SDS and HRQOL in children and adolescents without OSA.

Keywords: Adolescent; Child; Obesity; Obstructive sleep apnea; Overweight; Quality of life.

MeSH terms

Adolescent
Body Mass Index
Child
Cross-Sectional Studies
Humans
Obesity / complications
Obesity / epidemiology
Overweight / complications
Overweight / epidemiology*
Polysomnography
Quality of Life*
Sleep Apnea, Obstructive* / diagnosis
Sleep Apnea, Obstructive* / epidemiology