Vicious cycle of sleep apnea and obesity in kids
February 17th, 2012
03:20 PM ET

Vicious cycle of sleep apnea and obesity in kids

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

The classic pediatric sleep apnea patient is a skinny 6-year-old with chronic congestion and dark circles under his eyes.

We still see many kids in the sleep center who match this profile, but over the past 10 years, a new clinical picture has emerged. Coinciding with the dramatic rise in childhood obesity, there is a clear change in our younger patients.

We now see many overweight children in the sleep clinic who have obstructive sleep apnea that resembles the adult version.

The thin child with OSA does not usually act sleepy in the daytime. On the contrary, they often act hyperactive or inattentive. In fact, their symptoms can mimic attention deficit hyperactivity disorder.

Large tonsils and adenoids are the primary cause of OSA in thin children because these and surrounding tissues can relax during sleep and block the airflow to the lungs. In fact, 80 to 90% of such cases of pediatric OSA are cured by surgically removing the tonsils and adenoids.

Overweight or obese children are not such an easy fix. They usually present with loud snoring and significant daytime sleepiness. In obese children, the tonsils often become enlarged due to fatty tissues in the upper airway. Fat deposits in the neck and chest also add to the collapsibility of the upper airway during sleep.

Unfortunately, a tonsillectomy/adenoidectomy is curative in only about 50% of overweight kids who have OSA. The others are encouraged to try continuous positive airway pressure (CPAP) which is the most common treatment for severe OSA.

When adults have mild-to-moderate OSA, we offer them an alternative treatment called an oral appliance (also called a mandibular advancing device). However, we cannot use this treatment in children and teens whose mouth and jaw are still changing.

The important thing for pediatricians and parents to keep in mind is that the connection between weight and sleep is a two-way street.

It’s not just that excess weight increases the likelihood that kids have obstructive sleep apnea, but that having sleep apnea increases the risks of gaining weight.

Sleep deprivation due to poor sleep or too little sleep can cause hormonal havoc that leads to weight gain.

For example, when research subjects were allowed to sleep for only four hours per night, the hormones that control appetite got all out of whack. Leptin, which acts on the brain to make people feel full, was abnormally decreased and ghrelin, which makes people hungry, was unusually high.

These hormonal changes caused the research participants to be very hungry and eat more during the day.

Children and teens with sleep apnea might seem to be sleeping a lot, but their sleep is constantly disturbed by brief turbulence in their brain waves - what sleep experts call micro-arousals. In effect, these kids are as sleep deprived as people who only get four to five hours of sleep.

Not only do obese kids with OSA have a similar clinical presentation as adults, they unfortunately can have the same adverse outcomes if the sleep apnea is not treated. We are seeing pre-teens who have what we use to think of as adult diseases such as high blood pressure, pulmonary hypertension, heart disease and congestive heart failure.

If your child is overweight, please consult a doctor to find out if he or she has the symptoms of sleep apnea, such as snoring, rough breathing, daytime sleepiness, poor academic performance, behavior issues and depression.

OSA is easy to diagnose with an overnight sleep test and as I outlined above, there is more than one treatment option. Treating sleep apnea, if present, needs to be part of the weight loss program for everyone, including kids and teens.

soundoff (66 Responses)
  1. Anna

    Weight loss is simple when you learn the secret. If you have a stubborn insulin you hold fat and have a hard time losing weight. You can eat very little and the weight still does not come off. YOU HAVE STUBBORN INSULIN that holds fat and diets won’t work
    BUT when researchers used a specialized diabetes diet on people with OR without diabetes they lost the stubborn insulin and the weight
    just google SPIRIT HAPPY DIET

    February 17, 2012 at 19:10 | Report abuse | Reply
    • Patrick

      More snake oil.

      Eat right and exercise it’s not a secret.

      March 1, 2012 at 15:41 | Report abuse |
  2. Dani

    There are also people who, despite eating healthily and exercising, have naturally slower metabolisms.
    I had sleep apnea as a kid. The article isn't lying about removal of tonsils being curative. I ate ice cream and chocolate pudding for a week after surgery, and never had problems with sleep apnea again.

    February 17, 2012 at 20:06 | Report abuse | Reply
    • Patrick

      Your metabolism is sped up by exercising. The REAL issue is people that don’t lose weight are lying to themselves. So you took the stairs at work today…so what. That doesn’t mean you can have a donut now.

      March 1, 2012 at 15:44 | Report abuse |
  3. Joshua Rotenberg MD

    As a pediatrician/neurologist/sleep specialist, I have noted that the best pediatricians/Family docs in Texas recognize this link. It should be instinctive to refer a child or teen to a pediatric specialist for evaluation. Thank you for this article! Dr. Rotenberg, Houston, TX http://www.txmss.com

    February 18, 2012 at 14:04 | Report abuse | Reply
  4. thalakos

    now all u have to do is get the medical associations to convince insurance companies to pay for the CPAP machines. and possibly for one every year or two because as shocking as it sounds they're not cheap but they do break.

    February 20, 2012 at 03:43 | Report abuse | Reply
  5. Faith

    Amazon Verified PurchaseThis review is for the Nasivent Tube Anti Snoring, Snore and Anti Sleep Apnea Aid (Health and Beauty)I rnleetcy purchased the Nasivent Tube for my husband who has a long history of snoring. This product has reduced the noise level so tha once again we can sleep in the same room. Thank you so much for your wonderful product amazon.com, just look for Nasivent! good luck .

    April 14, 2012 at 12:05 | Report abuse | Reply
  6. Karen

    Our Good Night, Sleep Tight reward chart creates the perfect bedtime routine for children. It provides a step by step routine with tips and guidelines to help you give your child a healthy nights sleep and for you an evening to unwind. http://www.victoriachartcompany.com/sleep-chart.html

    May 1, 2012 at 23:06 | Report abuse | Reply
  7. John O'Shea

    Thank You for the excellent information Dr. Shives; we at Huneo are doing some exciting work with Stanford University Research which we hope will have a most positive impact in child health in the areas of sleep apnea, obesity and head injuries. Keep up your good work.
    John O'Shea

    May 21, 2012 at 11:09 | Report abuse | Reply
  8. Donald A Nitkin, DDS,MS

    Impossible to contact Dr. Lisa at her web site. Messages simply won't "send".

    July 16, 2012 at 20:30 | Report abuse | Reply
  9. Chelsea Sawyer

    Weight is really a factor in having sleep disorders like sleep apnea. Thus. we really have to watch our food intake and make sure we only consume what we need. When we have kids, we have to look into their diet to ensure that they are not eating more than what they need.

    August 19, 2013 at 04:04 | Report abuse | Reply
  10. Ali

    Thank you Doc for this wonderful info... i wetted till i was 13 .. stopped wetting then was diagnosed with OSA at sixteen .. i would like to input the relation between coughing while urinating and how it interrupts the urine flow ..

    January 15, 2016 at 00:56 | Report abuse | Reply
  11. pan hua

    te regala un 10 de descuento


    April 3, 2016 at 20:18 | Report abuse | Reply
  12. smith brown

    Minimum 10 off on New Fashion Shoes Co.,Ltd.- More Cheaper Fashion Style Men's At Aliexpress.


    April 5, 2016 at 20:08 | Report abuse | Reply
  13. jual baja wf bali

    good luck so many people will be thankful with your talking sweet website valuable information


    April 7, 2016 at 05:15 | Report abuse | Reply
  14. Vaughn Panganiban

    massage in


    October 2, 2016 at 10:54 | Report abuse | Reply
  15. seo citations

    rattlesnake servitude slippy amer boardman armorer joujon interminable lucien
    seo citations https://m566.info/c21w1zs

    March 28, 2020 at 15:30 | Report abuse | Reply
  16. Vera

    I contacted him for marriage help, He only said to me that i have come to the right place were i will be getting my heart desire without any side effect.He told me what i need to do,After it was been done,24 hours later,My Ex Husband called me on the phone and was saying sorry for living me and the kids before now and one week after my Husband called me to be pleading for forgiveness, I am so happy and overwhelmed that i have to tell this to the entire world to contact Robinson Buckler on his personal email address and get all your problem solve..No problem is too big for him to solve..He also cure herpes, Contact him for herpes cure too direct on: Robinsonbucler @{{gmail.}} com.https://robinbuckler. com....💕”💕”

    December 10, 2020 at 11:55 | Report abuse | Reply
  17. Mohamed Ferrero


    December 28, 2020 at 05:28 | Report abuse | Reply
  18. Karena Allaire

    Though you may be able to purchase some CPAP machines from a supplier or retailer at a cheaper price than buying directly from the manufacturer, keep in mind that you still need a prescription from your doctor.


    January 12, 2021 at 09:42 | Report abuse | Reply
  19. Yi Fiermonte

    I see something truly special in this website.


    January 17, 2021 at 23:34 | Report abuse | Reply
  20. Buy Real Twitter Retweets

    Thank you a lot for giving everyone such a nice possiblity to check tips from this web site. It's always so amazing plus stuffed with fun for me personally and my office mates to search your site the equivalent of thrice in 7 days to study the fresh guides you have. And lastly, I'm always contented concerning the extraordinary advice served by you. Selected two areas in this posting are really the very best we've ever had.


    February 2, 2021 at 03:27 | Report abuse | Reply
  21. vuasongbac

    Nice recipe


    February 6, 2021 at 10:27 | Report abuse | Reply
  22. vuasongbac

    I love this recipe


    February 8, 2021 at 09:12 | Report abuse | Reply
  23. thesufitrader

    Interesting point


    February 8, 2021 at 09:26 | Report abuse | Reply
  24. Hämtning av skrotbilar Trollhättan

    294159 442982Glad to be among the visitors on this awe inspiring web site : D. 459464

    February 18, 2021 at 15:54 | Report abuse | Reply
  25. Brazino

    298012 917913Wow! This could be 1 specific of the most helpful blogs Weve ever arrive across on this topic. Basically Superb. Im also an expert in this subject therefore I can realize your effort. 683968

    March 24, 2021 at 13:00 | Report abuse | Reply
  26. Julio Pinkleton

    Very good information. Lucky me I ran across your website by chance (stumbleupon). I've bookmarked it for later!


    March 27, 2021 at 23:30 | Report abuse | Reply
  27. Alphonse Byler

    This site was... how do I say it? Relevant!! Finally I have found something which helped me. Thank you!


    March 29, 2021 at 12:13 | Report abuse | Reply
  28. Mel Holberg

    I couldn’t refrain from commenting. Exceptionally well written!


    March 31, 2021 at 13:53 | Report abuse | Reply
  29. Malik Hatmaker

    Nice post. I learn something new and challenging on blogs I stumbleupon everyday. It will always be useful to read through content from other authors and use something from other websites.


    March 31, 2021 at 19:58 | Report abuse | Reply
  30. Craig Wasielewski

    This excellent website truly has all the info I wanted concerning this subject and didn’t know who to ask.


    April 1, 2021 at 20:22 | Report abuse | Reply
  31. Josie Anand

    Nice post. I learn something new and challenging on websites I stumbleupon everyday. It will always be useful to read articles from other authors and practice a little something from their web sites.


    April 1, 2021 at 20:48 | Report abuse | Reply
  32. bet888

    Football Coaching in The uk has undergone dramatic changes over modern times.|Teach your DB's to sit and/or jump the opposing team's favorite routes, especially on third or fourth and incredibly long.


    April 4, 2021 at 10:02 | Report abuse | Reply
  33. Johnnie Riesland

    This website was... how do I say it? Relevant!! Finally I've found something which helped me. Thanks a lot!


    April 5, 2021 at 19:55 | Report abuse | Reply
  34. Joni Lavy

    Very good blog post. I certainly appreciate this site. Thanks!


    April 7, 2021 at 04:01 | Report abuse | Reply
  35. wm casino Download ios

    Hey There. I found your blog using msn. This
    is an extremely well written article. I will make sure to bookmark it and come
    back to read more of your useful information. Thanks for
    the post. I'll certainly return.

    Here is my web page wm casino Download ios

    April 10, 2021 at 23:45 | Report abuse | Reply
  36. Kerrie

    Very nice post. I just stumbled upon your blog and wished to say that I have truly enjoyed surfing around
    your blog posts. In any case I will be subscribing to your
    feed and I hope you write again soon!

    my webpage ... wm casino for ios (Kerrie)

    April 11, 2021 at 02:48 | Report abuse | Reply
  37. Bennie Carlino

    I have noticed that car insurance businesses know the autos which are vulnerable to accidents along with other risks. In addition they know what style of cars are prone to higher risk and also the higher risk they've already the higher a premium rate. Understanding the straightforward basics regarding car insurance will let you choose the right style of insurance policy that will take care of your wants in case you get involved in any accident. Thank you sharing your ideas for your blog.


    April 12, 2021 at 19:26 | Report abuse | Reply
  38. mu đá kênh nào

    Go team! xem ket qua va ty le Sports memorabilia fans are lucky! There are many and varied articles and apparel available for an eager football fan. He/she can watch Sunday football wearing a preferred team jersey. Whether you choose to watch professional football games live, with fellow enthusiasts for just a favorite sports bar, possibly the convenience your home in front of that big screen TV, wearing your team's logo makes way display team loyalty and advertise that you are an avid fan to ensure that it is in is by the comfort from the home.


    April 16, 2021 at 18:28 | Report abuse | Reply
  39. trực tiếp bóng đá argentina

    Go department! xem tv kenh today Therefore, it is not a tricky task in which to get hold of these systems.|Make sure ALL your players get the proper study. Should you not get the loading phase of the trunk arm correct, it's challenging for your swing or throw to extract. There are thousands of online sports memorabilia sites.|Move the ball down industry 10 yards at some time. eat inside clock. Finally, no football bedroom would be complete without real footballs. At one end of record will be most probable home is.|The American odds furthermore called as money numbers. In 1935 the Heisman Trophy, was designed to be awarded to one of the most outstanding football player. Late Olayinka John (Ayogi) was the then coach of eleven brothers.


    April 18, 2021 at 07:05 | Report abuse | Reply
  40. nba finals

    Express Your Love For Soccer With Football Cufflinks bóng rổ Every sport has a way of promoting its game. Football fans are recognized for wearing things such as scarves and hats several fans decide either to make funny outfits too. The type that you with regard to needs staying light and soft this means you do not get angry. There are well known brands will be known for designing convey . your knowledge in relation to its sports gear. Rather opt for such brands when compared to scarves that are sold from street four corner.


    April 19, 2021 at 07:46 | Report abuse | Reply
  41. kenh truc tiep bong da

    There are several other traditions that always accompany the Navy football team link bóng đá For example, the "E" Bell rings whenever Navy beats Army in any of the three seasons of distraction. This bell is from the bridge of USS Enterprise, a famed World War II aircraft carrier. The way to a tradition since 1950. The Gokokuji Bell is a replica of an bell which brought towards the United States by Commodore Matthew Perry in 1854. The original bell, had been donated towards the Academy by his widow, was retur ned to Okinawa in 1987. This bell is also rung each time the team scores a football victory over their Army competing firms. This bell sits in front of Bancroft Hall in Annapolis.


    April 19, 2021 at 09:54 | Report abuse | Reply
  42. private transfer

    Awesome! Its truly awesome post, I have got much clear
    idea regarding from this paragraph.

    Also visit my website :: private transfer

    April 21, 2021 at 01:44 | Report abuse | Reply
  43. birkenstock madrid big buckle

    I've experienced both sides of the ball. As the coach Got the possibility for coach for a head coach and an assistant. As being a parent I've 2 sons that played both youth and college football. Both were average players. Knowing my place as a mom or dad AND as being a coach taught me to get through some difficult parenting years.. messi man city After you receive the motion down, begin to do the whole movement as one complete exercise rather than pausing an issue bag at chest height before troubling. This is an ideal time to video the lift or have a coach/teammate watch you and critique your form. There are no longer many guarantees in football or football training, but, I can damn-near guarantee that workout will elevate your blocking and tackling.


    April 21, 2021 at 15:25 | Report abuse | Reply
  44. wm casino test

    Hi there are using WordPress for your site platform?
    I'm new to the blog world but I'm trying to get started and create my own.
    Do you need any html coding knowledge to make your own blog?
    Any help would be greatly appreciated!

    Visit my web site wm casino test

    April 23, 2021 at 05:26 | Report abuse | Reply
  45. liverpool fc

    Therefore, it is simply not a tricky task in which to get your hands on these systems.|Make sure ALL your players obtain the proper teaching. If you do not get the loading phase of3. bundesliga the trunk arm correct, it's very difficult for your swing or throw to get better. There are thousands of online autographs sites.|Move the ball down the field 10 yards at some time. eat up the clock. Finally, no football bedroom would be complete without real footballs. At one end of the list will be most probable home benefits.|The American odds likewise called as money brands. In 1935 the Heisman Trophy, was manufactured to be awarded to the most outstanding football player. Late Olayinka John (Ayogi) was the then coach of eleven brothers.


    April 25, 2021 at 05:29 | Report abuse | Reply
  46. Cheap Shared Proxies

    I like the efforts you have put in this, thanks for all the great blog posts.


    April 25, 2021 at 09:14 | Report abuse | Reply
  47. kylian mbappe psg

    High rep C&P is a perfect exercise but may be difficult to do with a barbell.|Individual will undoubtedly top 5 fantasy football QB whenever next period of time. Get going, with implausible prospects of becoming well-known on the inside world of football! Advertising deadlift great form, you're fine.|The football draw game – rare to find real madrid – bayern munich them isn't it? But, most coaches concentrate on 40-speed when in reality increasing football game speed is one of the keys. Now it has developed up for a great business.|But, for a lot of guys, this can be in excess of 700-lbs.In addition to these not being big ticket items, do supporters would like these football fundraising principles?|However, you are not satisfied with the collection of merchandises you have.For example, the "E" Bell rings whenever Navy beats Army in any of the three seasons of training.|Therefore if they play inside, they will have to inside the football field very trivial.In the following practices the right gifts tempo up and evaluate them once again.|A team that has internal problems and conflicts has chances of failure. Nowadays, technicians access to information from anywhere they have to have. Now you should look in the forthcoming matches and compare the teams' ratings.|Over 24 years of coaching youth football.


    April 27, 2021 at 11:08 | Report abuse | Reply
  48. dvd-duplication-nashville45677.blogspothub.com

    This is my first time go to see at here and i am really impressed to read everthing at single place.

    April 29, 2021 at 11:18 | Report abuse | Reply
  49. spal v juventus

    They make researches and studies regarding each game and its players. Watch them closely during team drills when they want to work in tandem with other players. This is a perfect football strength exercise.|Try reading up these as well as apply the actual your own online football betting. When making bets,everton đấu với liverpool buying a be sure that you will win every different bet in which you make. This bell sits in front of Bancroft Hall in Annapolis.|By adding chains or bands, you should use a scaled-down bag but work the legs and back even harder. You can easily get online and look great reason websites offering this service. These games are patterned after American Football.|Dominate the clock and the a better chance of success. The higher priced football fundraisers that are sold, bring in more money per on sale.


    April 30, 2021 at 02:32 | Report abuse | Reply
  50. tottenham court road car park

    Watch the film and diagram auto mechanic play the group runs including repeats. I Tin tức chuyển nhượng Liverpool use traditional. Write down the play number and also the down and distance to the best of one's knowledge along with a caption for everybody play i.e. I would write play 1, 1 and 10, Pitch Sweep Right and diagram the blocking assignments as executed and the backfield player numbers. For your playoff game I would take excess time to jot down every player's number.


    May 3, 2021 at 09:23 | Report abuse | Reply
1 2

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.