Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic outcomes and neurocognitive deficits. Appropriate screening and intervention for OSA are crucial in the management of children with obesity. We performed a scoping review of international and national pediatric obesity (n = 30) and pediatric OSA (n = 10) management guidelines to evaluate the recommendations on OSA screening in pediatric obesity. Sixteen (53%) of the pediatric obesity guidelines had incorporated OSA screening to varying extents, with no consistent recommendations on when and how to screen for OSA, and subsequent management of OSA in children with obesity. We provide our recommendations that are based on the strength and certainty of evidence presented. These include a clinical-based screening for OSA in all children with body mass index (BMI) ≥ 85th percentile or those with rapid BMI gain (upward crossing of 2 BMI percentiles) and the use of overnight polysomnography to confirm the diagnosis of OSA in those with high clinical suspicion. We discuss further management of OSA unique to children with obesity. An appropriate screening strategy for OSA would facilitate timely intervention that has been shown to improve cardiometabolic and neurocognitive outcomes.

中文翻译：

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肥胖儿童和青少年的阻塞性睡眠呼吸暂停 (OSA) 筛查：国家和国际儿科肥胖和儿科 OSA 管理指南的范围审查

阻塞性睡眠呼吸暂停 (OSA) 是一种常见的并发症，影响高达 60% 的肥胖儿童和青少年。它与较差的心脏代谢结果和神经认知缺陷有关。适当的 OSA 筛查和干预对于肥胖儿童的管理至关重要。我们对国际和国家儿童肥胖 ( n  = 30) 和儿童 OSA ( n = 10) 管理指南进行了范围审查 ，以评估儿童肥胖 OSA 筛查的建议。16 份 (53%) 儿科肥胖指南不同程度地纳入了 OSA 筛查，但对于何时以及如何筛查 OSA 以及肥胖儿童 OSA 的后续管理没有一致的建议。我们根据所提供证据的强度和确定性提供建议。其中包括对所有体重指数 (BMI) ≥ 85% 或 BMI 快速增加（向上跨越 2 个 BMI 百分位数）的儿童进行 OSA 临床筛查，以及使用夜间多导睡眠图来确认这些儿童的 OSA 诊断临床高度怀疑。我们讨论肥胖儿童特有的 OSA 的进一步管理。适当的 OSA 筛查策略将有助于及时干预，已被证明可以改善心脏代谢和神经认知结果。