Abstract

Obstructive sleep apnea syndrome (OSAS) is characterised by episodic upper airway obstruction that occurs during sleep and is common in children with obesity. The aim of the present study was to analyse the association between baseline anthropometric markers and objective sleep quality measures at follow-up in school-aged children with OSAS. Four hundred and seven school-aged children with OSAS (age 6.5 ± 1.4 years; 51.4% female, 92.1% non-Hispanic or Latino) were included in this study from the Childhood Adenotonsillectomy Trial (CHAT) study database. For the analysis, general linear models and linear regression were tested for sleep quality outcomes using polysomnographic data at follow-up (7 months) including: wake after sleep onset, sleep efficiency, sleep latency and total sleep duration and anthropometric markers at baseline including: waist circumference, neck circumference and obesity (body mass index percentile ? 95). Children with obesity had lower sleep efficiency (p = 0.021) and higher sleep latency (p = 0.049) than children without obesity. Additionally, higher neck circumference values were associated with lower total sleep duration (p = 0.042). At the same time, higher waist circumference was associated with lower sleep efficiency (p = 0.016) and lower total sleep duration (p = 0.013). Our study highlights the intricate relationship between childhood OSAS, obesity and neck and waist circumference that influences sleep outcomes. Our findings showed that obesity at baseline leads to poorer sleep quality, lower sleep efficiency and higher sleep latency at follow-up, regardless of gender, age, ethnicity and adenotonsillectomy. These findings underscore the importance of addressing obesity, neck and waist circumference in paediatric OSAS. Trial Registration: NCT00560859. © 2025 The Author(s). Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.