Enough Zzzs? Sleep, Snoring, and Sleep Apnea Evaluation in Underinsured Overweight and Obese Children

Abstract

Category/Date Emerging Knowledge for Clinical Practice Podium Presentations focusing on the Research Agenda Priority of Pediatric Research: Professional Role & Health Promotion and Disease Prevention, Presented at NAPNAP's 40th National Conference on Pediatric Health Care, March 8, 2019, New Orleans, LA. Background The amount and quality of sleep children get each night is important to their health and well-being. Insufficient sleep and sleep disorders are frequently diagnosed in overweight and obese children. Sleep disorders, like sleep apnea, require referral to specialists for evaluation, diagnosis, and treatment. Uninsured families are less likely to seek preventative medical care because of high cost, lack of established care, transportation issues, and lack of insurance access. Therefore, uninsured children are less likely to visit providers for check-ups to receive sleep counseling, appropriate evaluation for sleep disorders, and referrals to specialist for sleep disorders when necessary. Objective To evaluate sleep quantity, snoring, and frequency of referrals to specialists for sleep apnea in uninsured, primarily Hispanic, overweight and obese children. Methods With IRB approval, a paper survey was given to 45 parents whose children were enrolling in a lifestyle modification program on a mobile clinic program that cares for uninsured children in Houston, TX. Children were recruited for the one month program because they were identified as overweight or obese at a well-child visit. Results The parents of 45 overweight/obese uninsured children ages 8-18 (42% male) were surveyed. 73% of the families surveyed had an annual family income less than $40,000. Only 4% reported that their child had been diagnosed previously with a chronic medical condition. The subjects were 91% Hispanic and Spanish was primary language spoken at home for 73% of families. Average reported number of hours of sleep at night: 6 hours or less (11%), 7-8 hours (67%), 9-10 hours (18%), and more than 10 hours (4%). Forty-four percent of parents reported that their child snores regularly. Although all patients enrolled were overweight or obese, there were no statistically significant differences between BMI and hours of sleep or frequency of snoring. Of those that reportedly snore, only 6% had received formal evaluation for sleep apnea. Conclusions Uninsured children may not be sleeping enough quality hours at night which is an understood risk factor for obesity. Overweight and obese uninsured children who snore may not receive sleep evaluation with a specialist due to barriers like high cost, poor insurance access, lack of established care, and transportation barriers. Further research is needed to understand how to reach uninsured children and provide recommended sleep counseling and evaluation for sleep disorders.