Impact of weight-loss management on children and adolescents with obesity and obstructive sleep apnea

May 11, 2019International journal of pediatric otorhinolaryngology

Weight-loss treatment and its effects on children and teens with obesity and sleep apnea

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Abstract

At the end of the study, the apnea-hypopnea index was normalized in 27 out of 62 children (44%).

A reduction in body mass index standard deviation score (BMI SDS) was significantly associated with a decrease in the apnea-hypopnea index (AHI) after approximately six months of treatment.
The study included 62 children aged 7-18 years with obstructive sleep apnea (OSA) and obesity.
Follow-up assessments showed that 89% of participants returned for the first follow-up and 85% of those with ongoing OSA attended the second follow-up.
No significant association was found between changes in BMI SDS and changes in AHI from the first to the second follow-up.

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OBJECTIVES: To evaluate the impact of weight-loss management on obstructive sleep apnea (OSA) in children and adolescents with obesity. We hypothesized that a reduction in the degree of obesity was associated with a reduction in the apnea-hypopnea index (AHI).

METHODS: OSA (AHI ≥2) was investigated using a type 3 portable sleep device (Nox T3) in children and adolescents aged 7-18 years with overweight or obesity (body mass index standard deviation score (BMI SDS) > 1.28) at enrollment in a chronic care multidisciplinary overweight- and obesity treatment clinic. Individuals with OSA were included prospectively and longitudinally. A follow-up sleep examination was performed after 6 and 12 months from baseline accompanied by anthropometric measurements.

RESULTS: At baseline, 62 children with OSA were included (median age = 13.4 years, median BMI SDS = 3.16). A total of 55 out of 62 children (89%) attended the first follow-up, and 29 out of 34 children (85%) with residual OSA attended the second follow-up. By the end of the study, the AHI was normalized in 27 out of 62 children (44%). In a multiple linear regression analysis, the decrease in BMI SDS was associated with the decrease in AHI upon the first follow-up (p = 0.02) independently of sex; age; baseline puberty stage; baseline tonsillar hypertrophy; baseline AHI; baseline BMI SDS; and time to follow-up. There was no association between change in BMI SDS and change in AHI from the first to the second follow-up (p = 0.81).

CONCLUSIONS: OSA improved during obesity treatment, and the reduction in BMI SDS was significantly associated with the reduction in AHI after approximately six months of treatment. This indicates that obesity treatment should be considered among the first-line treatments of OSA in children and adolescents affected by overweight or obesity.

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Impact of weight-loss management on children and adolescents with obesity and obstructive sleep apnea

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