Obstructive sleep apnea in children with hypothalamic obesity: Evaluation of possible related factors.

INTRODUCTION Hypothalamic obesity (HO) is a type of obesity which is caused by hypothalamic damage. HO can be complicated by obstructive sleep apnea syndrome (OSAS) due to anatomical narrowing of the upper airway and hypothalamic damage induced dysfunctionof the sleep control mechanisms.We aimed to explore the presence and severity of OSAS in children with HOandhypothesized the OSAS is more severe andfrequent in HO thanexogenous obesity (EO). METHODS This cross-sectional study was conducted among children aged 6.6-17.9 years. Subjects with HO(n=14) and controls with EO (n=19) were consecutively recruited through an endocrinology clinic. All patients underwent full-night polysomnography. The primary outcomeswerethe obstructive apnea-hypopnea index (OAHI) and the severity of OSAS.We analyzed the polysomnography findings, biochemical parameters, Brodsky and modified Mallampati scores,and blood pressure compared withthe controls. We explored the different obesity types and these variables in association withthe OAHIusing multiple linear regression (MLR). RESULTS Age and body mass index z-scores (BMI-z) were similar between the EO and HO groups.The OAHI of the HO (5.8) was higher than that of the EO (2.2).Inthe MLR, the predicted OAHI was formulated as an equation usingregression coefficients of obesity type (HO), age, and the BMI-z (R2 =0.41). In the logistic regression analysis, the odds ratio of moderate/severe OSA was 5.6 for HO. CONCLUSIONS Children with HO have a higher risk of moderate/severe OSAS than children with EO. Polysomnography should be considered in all patients with HO. This article is protected by copyright. All rights reserved.