Endocrine Abstracts

Background: Obstructive sleep apnoea (OSA) is characterised by recurrent upper airway obstruction during sleep resulting in abnormal ventilation and sleep patterns. Paediatric obesity is associated with a significantly increased OSA risk. Prompt recognition and management of OSA is important to reduce the risk of complications, including cardiovascular, growth, behavioural and glycaemic. We describe initial experiences of using the Paediatric Sleep Questionnaire (PSQ) to screen for OSA in severe paediatric obesity.

Method: 71 new patients seen in a tier-3 paediatric weight management clinic had a history taken and a PSQ performed. The PSQ is a 22-question validated screening tool, with 0.33 and 0.66 having previously been identified as cut-offs for likely mild and moderate/severe OSA respectively. Patients with a score of ≥ 0.33 and/or a history suggestive of OSA were referred to a tertiary paediatric respiratory team for further investigation using an oximetry study and/or cardiorespiratory sleep study (CrSS).

Results: Patients (38 male, 33 female) aged between 3.3-17.0 years (mean 12.0) with mean BMI-SDS 3.41(1.68-5.93). Mean PSQ score (table 1) was 0.48(0.05-0.91) and 59.2% patients were referred for respiratory assessment. 13 sleep studies have been completed (6 oximetry, 7 CrSS). 6/13(46.2%) were diagnosed with OSA requiring non-invasive ventilation and a further 3/13(23.1%) patients had borderline oximetry studies and are awaiting a formal CrSS.

Conclusions: Our preliminary data demonstrate that our weight management service is effectively screening for OSA, with several patients commencing NIV as a result of attending since questionnaire implementation. PSQ scores align with histories suggestive of OSA in this population and may assist with triaging for sleep studies. There is a paucity of evidence regarding effective screening for OSA in severe paediatric obesity and further work in this area is warranted.