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Total energy expenditure in children with obstructive sleep apnoea syndrome
R M Bland1, S Bulgarelli, J C Ventham
1University of Glasgow, Dept of Child Health, Yorkhill Hospitals, UK.
Insights
Childhood obstructive sleep apnoea syndrome (OSAS) does not increase total energy expenditure (TEE) in children. This study found no significant difference in TEE between children with OSAS and healthy controls, challenging previous hypotheses.
Area of Science:
- Pediatric pulmonology
- Sleep medicine
- Human physiology
Background:
- Childhood obstructive sleep apnoea syndrome (OSAS) is known to affect growth and nutritional status.
- Increased sleeping energy expenditure has been hypothesized as a mechanism for these effects.
- However, no studies have quantified total energy expenditure (TEE) in children with OSAS.
Purpose of the Study:
- To test the hypothesis that OSAS is associated with increased TEE in children.
- To investigate the relationship between OSAS and energy requirements.
Main Methods:
- A case-control study involving 11 children diagnosed with OSAS and 22 matched healthy controls.
- Total energy expenditure (TEE) was measured using the doubly-labelled water method.
- TEE was also assessed in 10 patients before and after adenotonsillectomy.
Main Results:
- No significant difference was found in TEE between children with OSAS and healthy controls.
- TEE in OSAS patients was comparable to age- and sex-specific literature data.
- Changes in TEE after adenotonsillectomy were minor and not statistically significant.
Conclusions:
- The findings do not support the hypothesis that childhood OSAS increases energy requirements.
- Alternative explanations for the impact of OSAS on growth and energy balance in children should be explored.
- This research contributes to understanding the metabolic consequences of pediatric OSAS.
Abstract:
Childhood obstructive sleep apnoea syndrome (OSAS) acts as a check on growth and nutritional status. An increase in sleeping energy expenditure has been proposed as a possible mechanism, but to date, no studies have determined whether energy requirements (total energy expenditure; TEE) are raised in OSAS. The aim of this study was to test the hypothesis that OSAS is associated with increased TEE. Eleven children (mean+/-SD 5.8+/-2.2 yrs of age) with OSAS confirmed by nocturnal polysomnography were each matched with a pair of healthy controls (n=22) of the same age and sex. TEE was measured using the doubly-labelled water method in all subjects. In 10/11 patients TEE was also measured after adenotonsillectomy and changes in TEE assessed. There was no significant difference in TEE between patients (mean+/-SD 325+/-44 kJ x kg(-1) x day(-1)) and controls (339+/-48 kJ x kg(-1) x day(-1)), nor between patients and age- and sex-specific literature data on TEE, using the doubly-labelled water method. Differences in TEE within patients, before versus after surgery, were minor and not statistically significant. This study does not support the hypothesis that obstructive sleep apnoea syndrome in childhood is associated with increased energy requirements, and suggests that alternative explanations for the effect of this syndrome on growth and energy balance should be sought.