Clinical Predictors of Residual Sleep Apnea after Weight Loss Therapy in Obese Adolescents

Annelies Van Eyck; Ann De Guchtenaere; Luc Van Gaal; Wilfried De Backer; Stijn L Verhulst; Kim Van Hoorenbeeck

doi:10.1016/j.jpeds.2017.12.056

Clinical Predictors of Residual Sleep Apnea after Weight Loss Therapy in Obese Adolescents

J Pediatr. 2018 May:196:189-193.e1. doi: 10.1016/j.jpeds.2017.12.056. Epub 2018 Mar 1.

Authors

Annelies Van Eyck¹, Ann De Guchtenaere², Luc Van Gaal³, Wilfried De Backer⁴, Stijn L Verhulst⁵, Kim Van Hoorenbeeck⁵

Affiliations

¹ Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium. Electronic address: Annelies.vaneyck@uantwerpen.be.
² Zeepreventorium VZW, De Haan, Belgium.
³ Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Department of Endocrinology, Diabetology, and Metabolism, Antwerp University Hospital, Edegem, Belgium.
⁴ Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Department of Pulmonology, Antwerp University Hospital, Edegem, Belgium.
⁵ Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium.

PMID: 29502877
DOI: 10.1016/j.jpeds.2017.12.056

Abstract

Objective: To investigate clinical factors that could predict residual sleep-disordered breathing (SDB) after weight loss.

Study design: Obese subjects between 10 and 19 years of age were recruited while entering an in-patient weight loss treatment program. All subjects underwent anthropometry and sleep screening using a portable device at baseline and after 4-6 months of therapy. Sleep and International Study of Asthma and Allergies in Childhood questionnaires were completed at baseline.

Results: A total of 339 patients were included. Median age was 15.4 years (10.1-19.1). Body mass index z score at baseline was 2.75 ± 0.42, and 35% of subjects were boys. SDB was present in 32%. After a mean decrease in body mass index z score of 32%, residual SDB was found in 20% of subjects with SDB at baseline. Subjects with more severe SDB (OR 1.18; CI 1.01-1.34; P = .02) and respiratory allergies (OR 7.85; CI 1.20-51.39; P = .03) were at higher risk of developing residual SDB, unlike age, sex, and anthropometric variables.

Conclusions: Weight loss was successful for treating SDB in 80% of patients. More severe SDB and the presence of respiratory allergies at baseline were associated with a higher risk of residual SDB after weight loss.

Keywords: adolescents; children; obesity; obstructive sleep apnea; sleep-disordered breathing; weight loss.

MeSH terms

Adolescent
Anthropometry
Body Mass Index
Child
Female
Humans
Hypersensitivity
Male
Pediatric Obesity / complications*
Pediatric Obesity / therapy
Polysomnography
Sleep
Sleep Apnea Syndromes / complications
Sleep Apnea Syndromes / diagnosis*
Treatment Outcome
Weight Loss*