INTRODUCTION: Obstructive sleep apnea (OSA) is a possible risk factor for metabolic syndrome even in children. OBJECTIVES: To examine the relationship between metabolic markers (glucose, insulin resistance, and lipids) and SDB in children and their impact on the quality of life. METHODS: Eighty-nine children between 3 and 12 years of age were matched into the following 4 groups: G1 - non-obese OSA; G2 - obese OSA; G3 - obese, and G4 - healthy controls. OSA was defined by polysomnographic results. The quality of life was assessed by the OSA 18 questionnaire. Metabolic markers (glucose, insulin, total cholesterol, HDL, LDL, VLDL, and TGL) were measured on a fasting morning blood sample and were compared among the 4 groups. RESULTS: OSA 18 revealed the negative impact of OSA on the quality of life of children in terms of sleep disturbance, physical suffering, and caregivers' concerns. OSA severity (IAHm) was similar in G1 and G2 groups. Insulin, HOMA and the glucose/insulin ratio were highest in obese children (G2 and G3), regardless of the presence of OSA. There was no difference in cholesterol levels among the 4 groups but HDL was higher in non-obese (G1 and G4) children. Triglyceride levels were higher in obese children without OSA (G3). CONCLUSIONS: OSA has a negative impact on the quality of life in children, but it had no impact on metabolic markers in our study population. Obesity was a determinant of metabolic dysfunction and insulin resistance.