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We evaluated 32 obese children [% ideal body weight (IBW), 196\u00b145%] with a sleep history questionnaire, airway radiographs, electrocardiograms (ECG), and PSG. By history, we found snoring (100%), difficulty breathing (59%), sweating (44%). restlessness (53%), arousals (41%), apnea (50%), worsening with upper respiratory infection (URI) (81%), hypersomnolence (59%), and mouth breathing (59%). We found adenoid and\/or tonsil enlargement on 75% of airway x\u2010ray pictures. ECGs were abnormal in 5 patients. Among all patients, mean sleep study oxyhemoglobin saturation (SaO<jats:sub>2<\/jats:sub>) was 85\u00b116% and mean end\u2010tidal CO<jats:sub>2<\/jats:sub> (PetCO<jats:sub>2<\/jats:sub> ) was 51\u00b17 torr; 84% had paradoxical inward movement of the chest on inspiration, 59% had OSA, and 66% had partial OSA. In those with \u2a7e200% IBW and adenotonsillar enlargement, elevated PetCO<jats:sub>2<\/jats:sub> and the presence of hypoxemia (SaO<jats:sub>2<\/jats:sub>&lt;90%) for \u2a7e5% of the total sleep time (TST) were correlated, unlike in patients of similar weight but without adenotonsillar enlargement. Individual symptoms did not correlate with the severity of PSG abnormalities. By discriminant analysis, using three variables (IBW, presence of adenotonsillar tissue, and presence of \u2a7e5 symptoms), we could predict PSG abnormalities with up to 81% reliability. Our findings indicate that in obese children, particularly those with %IBW \u2a7e200 and adenotonsillar hypertrophy, with sleep\u2010disordered breathing evaluation by polysomnography should be considered. Pediatr Pulmonol. 1993; 16:124\u2013129. \u00a9 1993 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.1950160208","type":"journal-article","created":{"date-parts":[[2007,3,6]],"date-time":"2007-03-06T18:40:24Z","timestamp":1173206424000},"page":"124-129","source":"Crossref","is-referenced-by-count":155,"title":["Polysomnography in obese children with a history of sleep\u2010associated breathing disorders"],"prefix":"10.1002","volume":"16","author":[{"given":"Jean M.","family":"Silvestri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra E.","family":"Weese\u2010Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle T.","family":"Bass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna S.","family":"Kenny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A.","family":"Hauptman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheilah M.","family":"Pearsall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,10,21]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.me.27.020176.002341"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(20)31250-0"},{"key":"e_1_2_1_4_2","first-page":"10","article-title":"Obstructive sleep apnea in older children","volume":"3","author":"Loughlin GM","year":"1982","journal-title":"J Respir Dis."},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950030610"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(89)80738-3"},{"key":"e_1_2_1_7_2","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1093\/sleep\/12.5.430","article-title":"Sleep pattern alterations and brief airway obstructions in overweight infants","volume":"12","author":"Kahn A","year":"1989","journal-title":"Sleep."},{"key":"e_1_2_1_8_2","first-page":"305","article-title":"Pulmonary vascular obstruction in the Pickwickian syndrome","volume":"2","author":"Robin ED","year":"1959","journal-title":"Clin Res."},{"key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1542\/peds.24.1.23","article-title":"Cardiorespiratory syndrome of obesity in a child","volume":"24","author":"Jenab M","year":"1959","journal-title":"Pediatrics."},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1960.02070030824018"},{"key":"e_1_2_1_11_2","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1542\/peds.27.2.237","article-title":"Cardiorespiratory syndrome of obesity (Pickwickian Syndrome) in children","volume":"27","author":"Cayler GG","year":"1961","journal-title":"Pediatrics."},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.40.4.419"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(62)80348-5"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1963.02080050253002"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1965.tb06371.x"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.98.363"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/000992286900800111"},{"key":"e_1_2_1_18_2","first-page":"671","article-title":"Complications of obesity\u2010 hypoventilation syndrome in childhood","volume":"130","author":"Riley DJ","year":"1976","journal-title":"Am J Dis Child."},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(77)80720-8"},{"key":"e_1_2_1_20_2","first-page":"29","article-title":"Sleep apnea in a child with the Pickwickian syndrome","volume":"60","author":"Simpser MD","year":"1977","journal-title":"Pediatrics."},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(88)90101-2"},{"key":"e_1_2_1_22_2","unstructured":"Metropolitan Height and Weight Tables. 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