Supine Sleep Research Articles

High Negative Predictive Value of Normal Body Mass Index for Obstructive Sleep Apnea in the Lateral Sleeping Position.

Obesity is a major risk factor for obstructive sleep apnea (OSA). Patients who are not obese and who have OSA usually present with a low apnea-hypopnea index (AHI) in the lateral sleeping position. Hence, sleep-disordered breathing (SDB) seems more dependent on body mass index (BMI) in the lateral sleeping position than the supine sleep position. This makes obesity a better predictor of SDB in the lateral sleeping position. The objective of this study was to find a negative predictive value of normal BMI for SDB in relation to sleep positions, thus defining a group of patients who could be treated by positional intervention, and prioritizing the use of polysomnography diagnostics. This study comprises a retrospective and prospective part run on groups of 1,181 and 821 consecutive patients, respectively. All had been referred to the university-based sleep laboratory because of suspected OSA and underwent polysomnography. In the retrospective study, areas under the receiver operating characteristic curves for normal BMI at AHI ≥ 5 and AHI ≥ 15 events/h were found to be larger in the lateral sleeping positing than supine: 0.79 versus 0.69 and 0.80 versus 0.68, respectively (P < .05). Comparable results were obtained in the prospective study. For normal BMI, the negative predictive value for AHI < 15 events/h in the lateral sleep position was 97.5% and 97.1% in the retrospective and prospective study, respectively. Normal BMI offers a high negative predictive value for moderate or severe OSA in the lateral sleeping position.

The effect of supine positioning on maternal hemodynamics during late pregnancy

Introduction: Recent studies have demonstrated an association between maternal supine sleep position and an increased risk of late stillbirth. During late pregnancy, the gravid uterus compresses the inferior vena cava (IVC) when a woman lies in the supine position. The azygos system of veins is the dominant pathway of collateral venous return back to the heart in the event of acute obstruction of the IVC. It is suggested that this pathway provides adequate collateral venous circulation in the event of IVC compression in the supine position during late pregnancy.Objective: Investigate the effect of supine positioning on maternal hemodynamics during late pregnancy and the role of collateral venous circulation.Methods: Ethics approval was obtained and 12 women with singleton pregnancies between 35- and 38-week gestation underwent magnetic resonance imaging in the supine and left lateral decubitus positions using a Skyra 3T system (Siemens). Phase-contrast images were evaluated to measure cardiac output, blood flow through the azygos vein, and blood flow through the abdominal aorta (AA) and IVC at two levels: at the level of aortic bifurcation and immediately above the renal veins.Results: The supine position was associated with a 16.4% reduction in cardiac output when compared to the left lateral position. In addition, blood flow through the IVC decreased at its origin by 85.3% and by 44.4% at the level of the renal veins. Blood flow through the azygos vein increased in the supine position by 220%. Blood flow through the AA at the level of the renal veins did not differ significantly; however, it is reduced by 32.3% at the level of the aortic bifurcation.Conclusions: Women in late pregnancy experience an increase in collateral venous blood flow when lying supine, likely as a response to marked compression of the IVC in this position. However, cardiac output and aortic blood flow were found to decrease while in the supine position.

2006 Formative evaluation and adaptation of a safe sleep intervention for infants in rural underserved communities

OBJECTIVES/SPECIFIC AIMS: This abstract describes a recently-funded 2 year study that aims to: (1) explore the community advisors’ perspectives of the safe sleep intervention’s acceptability, feasibility, and adaptability using focus groups and key informant interviews. (2) Adapt the selected safe sleep interventions (SSI) and identify promising implementation strategies to support it through an evidence-based quality improvement process with a multistakeholder group. METHODS/STUDY POPULATION: Background sudden unexpected infant death (SUID) is the leading cause of post-neonatal infant death in the United States. Sudden infant death syndrome (SIDS), accidental suffocation and strangulation in bed account for over 50% of SUID, leading to recommendations for supine sleep position and safer sleep environments for infants. However, despite significant reductions in SIDS after “back to sleep” and “safe to sleep” campaigns, significant racial and urban-rural disparities persist. In 2015, the rural-urban crude death rate ratio was 4:1 and Black infants are twice as likely to die from SUID as White infants. Adherence to safe sleep recommendations is highly variable and a number of hospital and community-based interventions have been suggested to improve knowledge and change parent behavior. Hospital programs to promote safe sleep education and policies may serve to educate families about safe sleep, but may not be uniformly available in rural and underserved areas. The AAP evidence-based safe sleep guidelines have demonstrated reductions in SIDS and SUID when child caregivers adhere to them. Community-based SSI, including safety baby showers, promote safe sleep practices, but barriers may exist for participation, especially in rural areas. Partnering with community groups serving a high risk area, we will explore the barriers and facilitators to more widespread safety baby shower (SBS) delivery/adoption in rural underserved communities (RUC). Observation of the evidence-based SBS as it is currently delivered, focus groups and key informant interviews will be conducted with program leaders and participants. Based on this knowledge and using an evidence-based development process, we will adapt the SBS and identify implementation strategies to support its uptake in RUC. RESULTS/ANTICIPATED RESULTS: We expect to develop a modified safe sleep intervention that reaches more expectant and new mothers is more efficient at delivering safe sleep guidelines to rural community members and can be more readily adopted and implemented by RUC. Supporting implementation strategies will be identified during the formative evaluation. DISCUSSION/SIGNIFICANCE OF IMPACT: Developing a safe sleep intervention adapted for the local context through a collective decision-making process between intervention experts and local community advisors will potentially improve safe sleep guideline delivery and adherence in RUC. The next study will pilot test the effectiveness of the adapted safe sleep intervention with identified supporting implementation strategies.

A systematic comparison of factors that could impact treatment recommendations for patients with Positional Obstructive Sleep Apnea (POSA)

Objective/BackgroundSystematically compare four criteria for Positional Obstructive Sleep Apnea (POSA) based on AASM 2007 and 2012 hypopnea scoring definitions. Patients/Methods142 records acquired by in-home polysomnography (Sleep Profiler PSG2™) were retrospectively analyzed using AHI based on the American Academy Sleep Medicine 2007 and 2012 criteria (AHI2007 and AHI2012). Positional obstructive sleep apnea (POSA) was characterized using four criteria: Amsterdam Positional OSA Classification (APOC), supine AHI twice the non-supine AHI (Cartwright), Cartwright plus the non-supine AHI < 5 (Mador), and the overall AHI severity at least 1.4 times the non-supine severity (Overall/NS-AHI). ResultsCorrelations between the Cartwright and Overall/NS-AHI criteria increased with the inclusion of a more relaxed definition of hypopneas (AHI2007 = 0.79 and AHI2012 = 0.86, P < 0.00001). The prevalence of POSA based on the Cartwright and Overall/NS-AHI criteria was approximately 60% in those with at least mild OSA by AHI2007and AHI2012. A 16% reduction in POSA prevalence for AHI2012 vs. AHI2007 was attributed to the increased incident of mild OSA. For identification of those expected to have 25% or 35% reductions in SDB severity with positional therapy, Cartwright and Overall/NS-AHI exhibited the strongest sensitivity and Overall/NS-AHI and Mador the best specificity. ConclusionsThe four criteria used to identify POSA have similarities and differences. While there were similarities between the Cartwright and Overall/NS-AHI criteria in the detection of POSA prevalence across both scoring criteria, the Overall/NS-AHI provided the most consistent detection of those most likely to demonstrate important reductions in sleep disordered breathing severity if supine sleep is avoided.

A novel method for comfort assessment in a supine sleep position using three-dimensional scanning technology

Mechanical interaction behavior between human body and mattress is one of the crucial physical factors affecting the sleep comfort and quality. This paper proposes a novel method for sleep (dis)comfort level assessment in a supine posture without interfering with sleep in an attempt to improve mattress design. Three-dimensional (3D) back surface model is constructed by scanning human body in an upright standing position. Based on the mechanical property of mattress and body pressure distribution measured by Tactilus system, finite element (FE) models are established to numerically calculate mattress upper surface indentation. Finally, Pearson correlation coefficient similarity measure is used to evaluate sleep (dis)comfort by compared back surface with mattress upper surface indentation. The experimental process is validated with two distinct types of mattress, namely palm fiber mattress and latex foam/palm fiber mattress. Results show that all the participants feel more comfortable when lying on latex foam/palm fiber mattress, which are in excellent agreement with the results obtained by body pressure distribution and spinal alignment.

1149 A Female with Neurodevelopmental Disorders, Obstructive Sleep Apnea and Supine NREM Catathrenia

1149 A Female with Neurodevelopmental Disorders, Obstructive Sleep Apnea and Supine NREM Catathrenia

Parental Experience of Sleep-Disordered Breathing in Infants With Cleft Palate: Comparing Parental and Clinical Priorities.

To identify outcomes relating to sleep-disordered breathing (SDB) that are relevant to parents, during the early weeks of caring for infants with cleft palate (CP), and compare these with clinical outcomes identified in a systematic search of research literature. A qualitative study using telephone/face-to-face interviews with parents explored their understanding of breathing and respiratory effort in infants with CP. Care provided by 3 specialist cleft centers in the United Kingdom, with study conducted in parents' homes. Criteria for participation were parents of infants with isolated CP aged 12 to 16 weeks. Thirty-one parents of infants with CP (over 12 weeks) were invited to participate in the interview. Interviews were completed with 27 parents; 4 parents could not be contacted after completing the sleep monitoring. Parents' description of infants' sleep suggests that breathing is not considered as a separate priority from their principal concerns of feeding and sleeping. They observe indicators of infants' breathing, but these are not perceived as signs of SDB. Parents' decision to use lateral or supine sleep positioning reflects their response to advice from specialists, observation of their infants' comfort, ease of breathing, and personal experience. Outcomes, identified in published research of SDB, coincide with parents' concerns but are expressed in medical language and fit into distinct domains of "snoring," "sleep," "gas exchange," and "apnea." Parents' description of sleeping and respiration in infants with CP reflect their everyday experience, offering insight into their understanding, priorities, and language used to describe respiration. Understanding parents' individual priorities and how these are expressed could be fundamental to selecting meaningful outcomes for future studies of airway interventions.

Evaluation of a Trial Period With a Sleep Position Trainer in Patients With Positional Sleep Apnea.

To assess the overall clinical effectiveness of a sleep position trainer (SPT) in patients with positional obstructive sleep apnea (POSA) and to evaluate how many patients were willing to continue treatment after a 1-month trial period. Patients in whom POSA was diagnosed underwent a 1-month trial period with the SPT. Home sleep apnea tests were used to measure baseline data and data following the trial period with the SPT. The 79 patients who completed the study protocol were 81% male, had a mean age of 52 ± 12 years, and a median baseline respiratory event index (REI) of 11 (8, 16) events/h. A significant reduction in overall REI to 5 (3, 10) events/h was observed with the SPT as compared to baseline (P < .001). The median percentage of sleep time in the supine position decreased significantly from 27 (20, 48) to 7 (2, 20) with the SPT (P < .001). Adherence was found to be 95 ± 8%. Of the 44 patients who decided to continue treatment, 27 were categorized as responders (having a decrease in REI of at least 50%) and 17 were non-responders. The most important reasons for not purchasing the SPT were poor objective results, intolerance to the vibrations, cost of the device, persistent daytime sleepiness, or patient preference for other treatment options. Treatment with the SPT came with high adherence rates and was effective in reducing REI and supine sleep position. The trial period is in the patients' best interest, as it may prevent those who will not benefit from positional training from purchasing an SPT.

The Impact of Health Messages on Maternal Decisions About Infant Sleep Position: A Randomized Controlled Trial.

Sudden infant death syndrome (SIDS) rates in African-Americans are more than twice national rates, and historically, African-American parents are more likely than other groups to place infants prone, even when they are aware of supine sleep recommendations. Prior studies have shown African-Americans have low self-efficacy against SIDS but high self-efficacy against suffocation. This study aimed to determine the impact of a specific health message about suffocation prevention on African-American parental decisions regarding infant sleep position. We conducted a randomized controlled trial of 1194 African-American mothers, who were randomized to receive standard messages about safe sleep practices to reduce the risk of SIDS, or enhanced messages about safe sleep practices to prevent SIDS and suffocation. Mothers were interviewed about knowledge and attitude, self-efficacy and current infant care practices when infants were 2-3 weeks, 2-3 months and 5-6 months old. Analyses of covariance were conducted to estimate the change in knowledge, attitudes and practice in each group, and chi square tests were used to compare sleep position with each variable. Over the first 6 months, the proportion of African-American infants placed supine gradually decreased and was unchanged by enhanced education about SIDS, suffocation risk and sleep safety. While initially high self-efficacy against SIDS and suffocation correlated with supine positioning, by 5-6 months self-efficacy did not correspond to sleep position in either group.

Obstructive sleep apnoea syndrome

Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Retrospective descriptive study of sleep tests conducted on children up to 14 years old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age was 5 years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, SatO 2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight. El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio. Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución. Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad. La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso.

Aside from supine sleep position, what interventions are effective in preventing sudden infant death syndrome (SIDS)?

Aside from supine sleep position, what interventions are effective in preventing sudden infant death syndrome (SIDS)?

Deformational plagiocephaly

Lay Summary: In industrialized societies some babies develop flattening of the back part of their head. It is thought that this comes from sleeping supine, which has been shown to be the safest option for babies. However, this explanation cannot be correct from an evolutionary standpoint: why should safe sleep come at the cost of a misshaped head?Babies in industrialized societies are generally healthy. The medical problems they may be afflicted with are usually well understood. Deformational plagiocephaly presents a notable exception. In many industrialized countries, one in six babies shows posterior flattening of the skull—a feature noteworthy from an evolutionary perspective as the well rounded cranium is part of the ‘Kindchenschema’ evolved to secure care for the infant. It is commonly held that the deformation of the posterior cranium occurs as a consequence of the supine sleep position, now advocated as the safest sleep position for babies by medical experts. This explanation, however, does not fare well in the light of evolutionary theory: why should safe sleep come at the cost of a social handicap? Here, we present an alternative hypothesis that is grounded on evolutionary mismatch theory and exemplifies how evolutionary reasoning can help clarify medical conditions relevant to today’s public health.

Residents' journal review

Residents' journal review

Patient-predicted sleep position vs. HST data: a tendency to underestimate supine sleep.

The purpose of this study is to measure people's accuracy when they estimate what proportion of their nightly sleep at home is supine vs. non-supine. A series of patients referred for obstructive sleep apnea (OSA) evaluation were asked if they "knew with confidence" how they slept with regard to their body position. "Yes" responders were then asked to estimate what percentage of their sleep was supine vs. non-supine. This value was compared with the actual proportion of supine vs. non-supine sleep that they exhibited in a home sleep test (HST) that followed. We obtained data from 49 subjects who expressed that they "knew with confidence" how they sleep in terms of body position. Subjects in aggregate underestimated their proportion of supine sleep by 21.6% (p<.001). Thirty-nine subjects (80%) slept supine more in the HST whereas 8 (16%) slept supine less compared to their pre-test estimates. Using a common classification of OSA severity, 9 subjects (18%) demonstrated a more severe degree of OSA than would have occurred had they slept as they had predicted. Subjects in this study frequently underestimated their proportion of supine sleep compared to values measured in an HST. Because of the increased supine sleep they exhibited, the severity of their OSA was often greater in the test than it would have been had the subjects slept as they predicted. Sleep physicians should take into account the tendency of people to underestimate supine sleep. If patients with positional sleep apnea assert that they "always sleep laterally" when at home, they may be underestimating their true night-by-night OSA disease burden.

An investigation of fetal behavioural states during maternal sleep in healthy late gestation pregnancy: an observational study.

Fetal behavioural state in healthy late gestation pregnancy is significantly affected by maternal position overnight. Maternal left lateral position is the one most frequently adopted at sleep onset. The maternal position at sleep onset is maintained the longest overnight. Fetal state 1F is more common in maternal supine positions overnight. Fetal state 4F is less common in maternal supine sleep positions. Fetal state and maternal sleep position are independently associated with fetal heart rate variability. Maternal sleep position significantly affects fetal heart rate and heart rate variability and affects circadian fetal heart rate patterns. Fetal behavioural states (FBS) are measures of fetal wellbeing. Maternal position affects FBS with supine position being associated with an increased likelihood of fetal quiescence consistent with the human fetus adapting to a lower oxygen consuming state. Several studies have now confirmed the association between sleep position and risk of late intrauterine death. We designed this study to observe the effects of maternal sleep positions overnight in healthy late gestation pregnancy. Twenty-nine healthy women had continuous fetal ECG recordings overnight. Two blinded observers assigned fetal states in 5min blocks. Measures of fetal heart rate variability (FHRV) were calculated from ECG beat to beat data. Maternal position was determined from infrared video recording. Compared to state 2F (active sleep), 4F (active awake-high activity) occurred almost exclusively when the mother was in a left or right lateral position. State 1F (quiet sleep) was more common when the mother was supine [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.11-1.52] and less common on the maternal right side with the left being the referent position (OR 0.81, 95% CI, 0.70-0.93). State 4F was more common between 21.00 and 01.00h than between 01.00 and 07.00h (OR 2.83, 95% CI 2.32-3.47). In each fetal state, maternal position had significant effects on fetal heart rate and measures of FHRV. In healthy late gestation pregnancy, maternal sleep position affects FBS and heart rate variability. These effects are probably fetal adaptations to positions which may produce a mild hypoxic stress.

TodaysBaby Quality Improvement: Safe Sleep Teaching and Role Modeling in 8 US Maternity Units.

Nursing education and role modeling can increase adherence to safe sleep practices. Eight US hospital maternity units with variable baseline approaches to education participated in a national multicenter nursing quality improvement (QI) intervention to promote safe sleep practices. The goals at participating maternity units were to (1) increase the rate of mothers who reported receiving safe sleep information from nurses to ≥90% and (2) increase the rates of infants observed sleeping supine in a safe environment to ≥90%. A safe sleep QI toolkit, designed for and provided to all sites, included an educational curriculum and tools to use for staff and parent education. Local teams implemented safe sleep education using the tools as plan-do-study-act cycles. After each cycle, audits assessing maternal report of nursing education on safe sleep and inpatient infant sleep position and environment were performed. The QI interventions lasted a median of 160 days (range, 101-273). Mothers reported receiving information on 4 primary safe sleep topics 72% to 95% of the time (a 24%-57% increase over the baseline). Additionally, 93% of infants were observed in a supine sleep position, and 88% of infants were observed in a safe sleep environment (a 24% and 33% increase over baseline, respectively). These rates were sustained up to 12 months later. Implementation of a multisite QI intervention for safe sleep parenting education and role modeling led to increased knowledge of and compliance with safe sleep practices during postpartum hospitalization.

Adherence to Safe Sleep Recommendations by Families With Higher-order Multiples.

More than 95% of higher-order multiples are born preterm and more than 90% are low birth weight, making this group of infants especially vulnerable to sudden infant death syndrome (SIDS). Emerging evidence suggests that families with twins face challenges adhering to the American Academy of Pediatrics (AAP) recommendations to reduce SIDS risks. Adherence to the AAP recommendations in families with higher-order multiples has not been described. This study describes SIDS risk reduction infant care practices for higher-order multiples during the first year of life. Mothers caring for higher-order multiple-birth infants were recruited from an online support group. An online survey was used to assess infant care practices when the infants were first brought home from the hospital as well as at the time of the survey. Ten mothers of triplets and 4 mothers of quadruplets responded. Less than 80% of the mothers practiced "back to sleep" immediately postdischarge. Supine sleep positioning decreased over time, particularly during daytime naps. Only 50% of the infants shared the parents' bedroom and approximately 30% bed-shared with their siblings. Sleep-time pacifier use was low. Safe sleep education must include specific questions regarding home sleeping arrangements, encouragement of breast milk feedings, supine positioning, and pacifier use at every sleep for higher-order multiple infants well before discharge in order for parents to plan a safe sleep environment at home. Prospective studies to identify barriers and facilitators can inform future strategies supporting adherence to safe sleep practices for higher-order multiple infants.

Improvements in Infant Sleep Position: We Can Do Better!

* Abbreviations: AAP — : American Academy of Pediatrics SIDS — : sudden infant death syndrome SUID — : sudden unexpected infant death On the basis of the New Zealand Cot Study and European data, in 1992 the American Academy of Pediatrics (AAP) recommended that infants no longer sleep in the prone position.1 By 1994, the National Institutes of Health, with other stakeholders, introduced the Back to Sleep campaign. Over the next 10 years, the sudden infant death syndrome (SIDS) rate in the United States fell 53%, correlating with an increase in exclusive supine sleep from <10% to 78%.2 The AAP considers this 1 of the 7 great achievements in pediatric research in the last 40 years.3 But since 2002, the story has become more complicated. The AAP recommendations evolved to back is better than side and then back only in 2005. Other risk factors emerged, such as soft bedding and bed-sharing, and the education campaign became Safe to Sleep in 2012.4 And although the incidence of SIDS continued to decline, other deaths (including accidental suffocation and strangulation in bed and undetermined deaths) began to increase, suggesting a possible “diagnostic coding shift.”5 These sleep-related deaths became … Address correspondence to Michael Goodstein, MD, Office of Newborn Medicine, York Hospital, 1001 S. George St, York, PA 17403. E-mail: mgoodstein{at}wellspan.org

Half of Mothers Do Not Exclusively Place Infants in the Supine Sleep Position

Since the “Back-to-Sleep” campaign was initiated in 1994 by the American Academy of Pediatrics (AAP) and other child health organizations to promote supine sleep positioning for infants, rates of sudden infant death syndrome (SIDS) have fallen, but thousands of infant deaths have still occurred every year. To further reinforce the “Back-to-Sleep” recommendations, the AAP published guidelines in 2005 advising that infants be placed exclusively in the supine position for sleeping. Now, to …

Obstructive sleep apnoea syndrome

Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight.