BMI Percentile a potential tool for predicting pediatric obstructive sleep apnea

Document Type

Article

Publication Date

6-1-2010

Description

Many physicians are reluctant to order overnight polysomnography studies in children to definitively diagnose sleeping disorders because of a lack of expertise in the field, high cost of the examination, or inducing the anxiety of separating the child from its family. The study questioned what if any relationship existed between body mass index (BMI) percentile and pediatric obstructive sleep apnea, and if so, can BMI percentile be used as an additional screening tool (in conjunction with primary snoring) to warrant polysomnography testing. The relevance of discovering such a relationship would be the addition of a noninvasive diagnostic trigger useful to clinicians, specifically pediatricians, as a differential to the diagnosis of OSA. This trigger would add validity to ordering polysomnography testing to diagnose or rule out OSA in pediatric patients. We performed a retrospective chart review of 158 pediatric patients who were tested for OSA in a pediatric sleep laboratory in Northeast Tennessee. Of those 158 patients undergoing overnight polysomnography, 129 were found to be positive for OSA. Of the 129 positive for OSA, 117 were at the tails of the distribution for BMI and fell in the less than fifth percentile for body mass index (BMI) or greater than the ninety-fifth percentile for BMI. This study was significant using the one way Chi Square method (Alpha=.05, p=.770). The significance of these findings to clinical practice in pediatrics is that in conjunction with primary snoring, OSA may be predicted by looking at the child's BMI percentile. If the child's BMI percentile is less than the 5th percentile or greater than the 95th percentile, overnight polysomnography is indicated when considering a diagnosis of OSA.

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