Prevalence of high risk for obstructive sleep apnea and its impact on quality of life in children with overweight and obesity.

STUDY

OBJECTIVES

To determine the prevalence of high risk for obstructive sleep apnea (OSA) in children with overweight and obesity and evaluate its impact on quality of life.

METHODS

We conducted a cross-sectional study of children aged 2-12 years diagnosed with overweight or obesity according to World Health Organization body mass index-for-age z-scores (BMIz). OSA risk and quality of life were assessed using the Thai version of the Pediatric Obstructive Sleep Apnea Screening Tool (POSAST) and the OSA-18 questionnaire, respectively. Physical examination included standardized tonsillar assessment using the Brodsky grading scale. Logistic regression models adjusted for potential confounders were applied in the data analyses.

RESULTS

Among 68 children with overweight and obesity, the prevalence of high OSA risk was 41.2% based on POSAST criteria. Tonsillar hypertrophy was the strongest predictor of high OSA risk (adjusted OR: 10.92, 95% CI: 3.04-39.15, p < 0.001). Twenty-one percent of children experienced moderate to severe quality-of-life impairment. High OSA risk (adjusted OR: 14.59, 95% CI: 1.94-109.86, p = 0.009) and attention-deficit hyperactivity disorder (adjusted OR: 11.84, 95% CI: 1.52-92.14, p = 0.02) were independently associated with diminished quality of life after controlling for age, sex, and obesity severity.

CONCLUSIONS

High OSA risk is prevalent among Thai children with overweight and obesity and significantly impairs their quality of life. Tonsillar hypertrophy represents a major treatable risk factor. These findings underscore the need for systematic OSA screening in pediatric obesity clinics and integration of quality-of-life assessments into routine clinical practice.