ABSTRACT
Introduction: Obesity affects about 10% to 15% of our school-going population in Singapore and is a risk factor for development of obstructive sleep apnoea hypopnoea syndrome (OSAHS). This article reviews the prevalence, aetiology, pathophysiology, diagnosis, complications and treatment of obese children with OSAHS with particular reference to children in Singapore.
Methods: Review of articles or conference papers reporting data with regards to OSAHS in Singapore children. Results: Prevalence of OSAHS was high in obese children in Singapore and was more common in males with no racial predisposition. Hypersomnolence as a presenting symptom was uncommon. Cognitive function, behaviour, attention and processing speed was affected and improved after intervention. Abnormalities of glucose metabolism were also found with the respiratory disturbance index (RDI) as an independent predictor of insulin resistance. Tonsillectomy and or adenoidectomy was efficacious as treatment and risk of complications was low. No significant increase in weight occurred post intervention in those enrolled in concurrent weight management programmes. Conclusions: Prevalence of OSAHS is high in obese Singapore children and many are ‘asymptomatic’. A low threshold for evaluation is necessary for early diagnosis and intervention for prevention of morbidity. Tonsillectomy and/or adenoidectomy is safe and efficacious and remains the first-line treatment in most obese patients.Obesity is becoming a problem of epidemic proportions and is perhaps, the most pervasive medical problem faced by medical providers today. It is a problem affecting about 10% to 15% of our school-going population in Singapore, affecting disease burden in virtually every medical subspecialty.
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