Childhood sleep-disordered breathing disproportionately affects obese and African-Americans

As the obesity epidemic grows in the U.S., doctors are discovering more and more far reaching health concerns for overweight children.

Sleep-disordered breathing (SDB), which can include various sleep behaviors ranging in severity from snoring to obstructive sleep apnea (OSA), disproportionately affects children who are overweight and African- American, according to a new study published in the December 2007 edition of Otolaryngology - Head and Neck Surgery. Obstructive sleep apnea (OSA) can pose serious health threats, including hypertension and higher risk for cardiac disease.

Researchers at Virginia Commonwealth University Medical Center in Richmond studied 299 children, ages 2 to 18 years old. The principal study group consisted of children scheduled to undergo adenotonsillectomy for treatment of SDB. The control group consisted of children presenting to a primary care pediatric clinic for well-child visits on randomly selected dates.

Each child's chart was reviewed for demographic data that included age, gender, race/ethnicity, height, and weight. Body mass index was calculated from the height and weight of each child.

Results showed that 46 percent of children scheduled for surgery for SDB were overweight, compared with 33 percent in the control group. This ratio is far less than would be expected in the general population, where obesity in children with SDB would occur approximately ten times more commonly than obesity in the general pediatric population. A possible explanation for the smaller ratio of obesity in children with SDB compared to controls, is that there may be a lack of awareness of the link between obesity and SDB among primary healthcare providers and caregivers.

Results also showed that children who are African-American and have SDB were more likely to be obese.

“The need to promote awareness of the association between SDB and obesity, particularly in African- American children and adolescents, among educators, caregivers, primary care providers, and the general public cannot be overemphasized,” said study lead author Emily F. Rudnick, MD.

Authors noted that in general there is clearly a complex role that race and ethnicity play in predicting obesity and SDB, and encouraged additional research into this public health issue.