Patterns of Childhood Obesity and Relation to Middle-Age Sleep Apnea Risk: The Bogalusa Heart Study.

Background: Patients with obesity have high risk of obstructive sleep apnea (OSA); however, the relationship between childhood obesity and later OSA risk is unknown. Methods: We prospectively examined the association between changes in overweight/obesity status in childhood and subsequent OSA in 823 middle-aged adults free of cardiovascular diseases at baseline and who had at least 2 measures of body mass index (BMI) between 4 and 18 yrs old (1974-) and responded to the Berlin Questionnaire in 2010. Childhood overweight/obesity was defined as age and gender specific BMI =85th percentile based on 2000 CDC Growth Charts. Four groups were generated based on change in obesity status from the earliest to most recent visit in childhood: persistent normal weight, incident overweight (from normal to overweight), weight loss (from overweight to normal), and persistent overweight. Based on Berlin Questionnaire, high-risk OSA was defined as any 2 of the following: obesity or hypertension, persistent snoring symptoms, and persistent daytime sleepiness. Persistent snoring was defined as snoring on =3 nights/week, snoring louder than talking or very loud, and breathing pauses on =3 nights/week; and persistent daytime sleepiness was defined as feeling tired =3 days/week after sleeping, feeling tired during time awake =3 days/week, and falling asleep while driving. Results: Mean age was 42 yrs and mean BMI was 31.0 kg/m² in adulthood. Of the total, 43% were male, and 34% were African-American. There were 604, 68, 39, and 112 persons in the persistent normal weight, incident overweight, weight loss, and persistent overweight groups, respectively. Median time between measures of BMI in childhood was 5 yrs (IQR: 5 yrs) across the 4 groups. Over an average of 35 years follow-up from childhood to adulthood (IQR: 1 yr), 326 (38%) participants had high-risk of OSA. In multivariate log-linear regression models, compared to participants in persistent normal weight group, those in persistent overweight, incident overweight, and weight loss groups had 1.80 (95% CI: 1.48, 2.19), 1.61 (1.22, 2.12), and 1.28 (0.89, 1.87) times higher risk of OSA, after adjustment for age, gender, race, educational level, leisure-time physical activity, regular drinking, and current smoking. The persistent overweight group had significantly higher risk of persistent snoring symptoms than persistent normal group (RR: 1.39; 95% CI: 1.12, 1.73). Results were not statistically significant for persistent daytime sleepiness among the groups. Conclusions: Persistent overweight or change from normal weight to overweight in childhood was associated with a higher risk of OSA in middle age, while weight loss during childhood did not have higher risk of OSA in adulthood compared to their counterparts in the persistent normal weight group. [ABSTRACT FROM AUTHOR]