Sleep Apnea: A Risk Factor for Obese Burned Children During the Rehabilitative Phase of Injury

Abstract

Obesity is associated with sleep disturbances that negatively impact general health. Recent reports indicate a high prevalence of obesity in burned children during the rehabilitative phase of injury. This retrospective review examined the relationship between sleep apnea and obesity in children recovering from burn injury. Nineteen subjects (mean age 14.0 ± 0.9 years, 8.0 ± 0.9 years postburn, TBSA burn 55.6 ± 7.0%, full-thickness burn 52.7 ± 8.7%) were examined for polysomnographic and respiratory outcomes. The groups were differentiated by body mass index (BMI). The obese group was defined as having a BMI ≥90th percentile according to age and gender specifications as defined by the Centers for Disease Control and Prevention. The BMI of the nonobese group was below the 90th percentile. Using t-test or χ, sleep and respiratory recordings were compared between the obese and the nonobese groups. The mean age, percent burn, percent full-thickness burn, years following acute injury, and the percentage of patients with burns to the neck region were similar in both groups; however, by design, BMI was significantly different. Total sleep time; sleep efficiency; sleep latency and time spent in stages 1, 2, 3; and rapid eye movement were similar between groups. Nonetheless, the number of apneic episodes, respiratory disturbance index, and oxygen desaturation measures were significantly higher in the obese group. In view of the significant respiratory disturbances apparent in pediatric burn survivors, routine appraisal of respiratory symptoms during sleep is recommended. In comparison to their normal weight counterparts, obese burned children appear to be at substantially greater risk of sleep-related respiratory compromise multiple years after an acute burn injury.