ABSTRACT
Emerging evidence has increasingly linked obstructive sleep apnea (OSA) to the development of nonalcoholic fatty liver disease (NAFLD) as well. Hypoxic stress associated with OSA and chronic intermittent hypoxia (CIH) may elicit a broad range of pathologic events that include sympathetic activation, systemic inflammation, impaired glucose and lipid metabolism and endothelial dysfunction. With mounting experimental evidence linking OSA/CIH with NAFLD, it is important to understand the clinical implications for patients with both obesity-related conditions. The gold standard for OSA diagnosis is multichannel polysomnography to assess multiple physiologic parameters simultaneously. Continuous positive airway pressure is the gold standard treatment for OSA. The prevalence of OSA in pediatrics varies widely based on the criteria used and has been reported in up to 13% of children. Furthermore, serum leptin levels correlate strongly with OSA severity as measured by apnea hypopnea index and prolonged hypoxemia.
