Young Male Adolescents With High BMI at Risk for Moderate to Severe OSA

Adolescent male patients with a higher body mass index (BMI), adenotonsillar hypertrophy, and sleep-disordered breathing have an increased risk of moderate to severe obstructive sleep apnea (OSA), according to findings presented at the American Thoracic Society (ATS) 2021 International Conference, held virtually from May 14 to May 19, 2021.

The researchers sought to investigate the correlation between adolescents with persistent asthma and moderate to severe OSA compared with mild intermittent exercise-induced asthma. A total of 231 patients between the ages of 11 to 17 years diagnosed with asthma were given in laboratory polysomnograms for sleep-disordered breathing symptoms (eg, snoring, witnessed apneas, excessive daytime sleepiness, and insomnia) and evaluated from 2017 to 2019.

Health records provided information on asthma severity, inhaled steroid prescriptions, comorbidities, and polysomnographic data. Researchers assessed asthma severity while adjusting for gender, race, BMI, and adenotonsillar hypertrophy and performed a T-test to determine mean apnea-hypopnea index (AHI).

Of the 231 patients with asthma, the majority were male (54.5%) and of White race [WU1] (30.7%) with a mean age of 13.6(±0.14) and BMI of 30.0(±9.8[WU2] ). The patients were diagnosed as either having persistent (27.3%), exercise induced (43.3%), mild intermittent (23.4%), or unspecified (6.1%) asthma There was a mean AHI of 12.1 events per hour in adolescents with persistent asthma (SE, 1.9; 95% CI[WU3] , 8.4-15.9) and in patients with milder forms of asthma (SE, 1.5; 95% CI, 10.9-16.8).

There was no significant association between adolescents given inhaled steroids with patients not treated with steroids (mean AHI difference, 0.36; 95% CI, -4.77 to -5.49; P =0.89). When study researchers adjusted for BMI, sex, race, and adenotonsillar hypertrophy, they found no correlation between moderate to severe OSA and persistent asthma. However, they did find a correlation between moderate to severe OSA and BMI (odds ratio [OR], 1.07; P =0.001), male sex (OR, 2.41; P =0.02) and adenotonsillar hypertrophy (OR, 3.11; P =0.006).

Despite the previous positive association found in children, there was no correlation between asthma and an increased risk for OSA in young adolescents.[WU4]  The researchers concluded “moderate to severe OSA was associated with higher BMI, male [sex], and adenotonsillar hypertrophy.”

Reference

Jayaram S, J Carter C, J Birnkrant D, Ayache M. Asthma and obstructive sleep apnea in adolescents. Presented at: the American Thoracic Society (ATS) 2021 International Conference; May 14-19, 2021. Abstract A3244