The prevalence of P-OSA was higher among overweight and obese groups, with the obese group experiencing the highest rates of severe OSA, more frequent hypoxemia, and reduced REM sleep duration.
Obese children with OSA had significantly elevated respiratory indices compared to all other weight groups.
Obese children with OSA had lower oxygen saturation levels during both NREM and REM sleep compared to normal weight children.
The proportion of children with severe OSA was highest in the obese group.
Normal weight and underweight children with OSA had higher percentages of REM sleep than obese children.
The incidence of positional OSA (P-OSA) was significantly higher in overweight and obese children compared to normal weight and underweight children.
The incidence of REM-related OSA (R-OSA) did not differ significantly among the four weight groups.
Significant gender differences were observed between certain weight groups.
This research suggests that body weight plays an important role in how obstructive sleep apnea (OSA) — a condition where breathing repeatedly stops during sleep — affects children's sleep patterns and severity. By analyzing sleep study records from children seen between 2017 and 2022 and grouping them by weight (underweight, normal weight, overweight, and obese), researchers found that obese children had the most severe forms of OSA, the most breathing disruptions, the lowest blood oxygen levels during sleep, and the least amount of REM (dream-stage) sleep compared to children of normal weight. The study also identified differences in OSA subtypes by weight. Positional OSA — where symptoms are strongly tied to sleeping position — was more common in both overweight and obese children than in normal or underweight children. In contrast, REM-related OSA (where breathing problems occur mainly during dream sleep) did not differ significantly by weight group. Interestingly, adenoid size, which is often a key factor in childhood OSA, did not differ meaningfully across weight groups, suggesting that weight-related factors may operate through different mechanisms. This research suggests that clinicians should consider a child's weight status when diagnosing and managing OSA, as obese children may need more intensive monitoring and treatment given their higher risk of severe disease and dangerous drops in blood oxygen. The higher rate of positional OSA in overweight and obese children also opens the possibility of position-based therapies as part of a personalized treatment approach for these patients.
Luo C, Li Q. (2026). [Differential study on sleep architecture and sleep subtypes in children with OSA in different weight states].. Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery. https://doi.org/10.13201/j.issn.2096-7993.2026.03.012