Published ahead of print on December 10, 2004, doi:10.1164/rccm.200403-398OC
Am. J. Respir. Crit. Care Med., Volume 171, Number 6, March 2005, 659-664
A more recent version of this article appeared on March 15, 2005
Submitted on March 29, 2004
Accepted on December 6, 2004
Associations of Obesity, Sleep Disordered Breathing, and Wheezing in Children
Loreto G Sulit1*, Amy Storfer-Isser1, Carol L Rosen1, H. Lester Kirchner1, and Susan Redline1
1 Department of Medicine, Case University School of Medicine, Cleveland, OH, USA
* To whom correspondence should be addressed. E-mail: loreto.sulit{at}case.edu.
Although it has been speculated that rising asthma rates may be partly due to increasing obesity, the causal mechanisms that relate these conditions are unclear. We assessed the extent to which sleep disordered breathing may explain associations between obesity and wheezing/asthma. 788 participants (ages 8-11 years) in a community-based cohort study were classified according to two outcomes: wheezing and asthma. Sleep apnea was defined as an increased number of apneas and hypopneas on overnight monitoring. Sleep disordered breathing was identified on the basis of either sleep apnea or habitual snoring. Multiple logistic regression models showed that children with wheeze were significantly more likely to be male [Odds Ratios (OR)1.62; Confidence Interval (CI) 1.15, 2.29], black (OR 1.90; CI 1.35, 2.29), obese (OR 1.57; CI 1.10, 2.44) and have a maternal history of asthma (OR 1.93; CI 1.16, 3.22). Further adjustment for sleep disordered breathing attenuated the association between obesity and wheeze (OR 1.45; CI 0.93, 2.26), but did not substantially alter the association between obesity and asthma. We conclude that sleep disordered breathing and obesity each are associated with asthma and wheeze. The relationship between obesity and wheeze may be partly mediated by factors associated with sleep disordered breathing.
Key words: Obesity, sleep disordered breathing, asthma
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