Adolescent boys with a higher body mass index (BMI), adenotonsillar hypertrophy, and sleep-disordered breathing have an increased risk for moderate to severe obstructive sleep apnea (OSA), according to findings presented at the American Thoracic Society (ATS) 2021 International Conference, held virtually.

The researchers sought to investigate the correlation between adolescents with persistent asthma and moderate to severe OSA compared with mild intermittent exercise-induced asthma. A total of 231 patients aged 11 to 17 years diagnosed with asthma were given in laboratory polysomnograms for sleep-disordered breathing symptoms (eg, snoring, witnessed apneas, excessive daytime sleepiness, and insomnia) and evaluated from 2017 to 2019.

Health records provided information on asthma severity, inhaled steroid prescriptions, comorbidities, and polysomnographic data. Researchers assessed asthma severity while adjusting for gender, race, BMI, and adenotonsillar hypertrophy and performed a T-test to determine mean apnea-hypopnea index (AHI).

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Of the 231 patients with asthma, the majority were male (54.5%) and 30.7% were White. The mean age was 13.6 years (±0.14) and BMI was 30.0 (±9.8). The patients were diagnosed as either having persistent (27.3%), exercise-induced (43.3%), mild intermittent (23.4%), or unspecified (6.1%) asthma. The mean AHI was 12.1 events per hour in adolescents with persistent asthma (SE, 1.9; 95% CI, 8.4-15.9) and 13.9 events/hour in patients with milder forms of asthma (SE, 1.5; 95% CI, 10.9-16.8); this difference was not statistically significant.

After adjusting for BMI, sex, race, and adenotonsillar hypertrophy, the researchers found no correlation between moderate to severe OSA and persistent asthma. However, they did find a correlation between moderate to severe OSA and BMI (odds ratio [OR], 1.07; P =0.001), male sex (OR, 2.41; P =0.02), and adenotonsillar hypertrophy (OR, 3.11; P =0.006).

Despite the previous positive association found in children, there was no correlation between asthma and an increased risk for OSA in adolescents. The researchers concluded “moderate to severe OSA was associated with higher BMI, male [sex], and adenotonsillar hypertrophy.”


Jayaram S, J Carter C, J Birnkrant D, Ayache M. Asthma and obstructive sleep apnea in adolescents. Presented at: the American Thoracic Society (ATS) 2021 International Conference; May 14-19, 2021. Abstract A3244

This article originally appeared on Pulmonology Advisor