Pulmonary function and sleep-related breathing disorders in severely obese children
Beatrice Dubern1, Patrick Tounian, Noria Medjadhi
1Armand-Trousseau Teaching Hospital, Department of Pediatric Gastroenterology and Nutrition, Avenue du Dr Arnold Netter, Paris, France.
Insights
Severely obese children often experience impaired pulmonary function and sleep-breathing disorders, with these issues linked to obesity phenotypes and reduced upper airway conductance.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Obesity Research
Background:
- Severe obesity in children is associated with various health complications.
- Pulmonary function and sleep-disordered breathing are common concerns in this population.
Purpose of the Study:
- To determine the prevalence of pulmonary function abnormalities and sleep-breathing disorders in severely obese children.
- To investigate the relationship between these disorders and obesity phenotypes.
Main Methods:
- 54 severely obese children underwent polysomnography (sleep studies) and spirometry.
- Data analyzed for upper airway resistance, lung volumes, and sleep parameters.
Main Results:
- 83% had increased upper airway resistance, and 60% showed reduced forced expiratory volume.
- 43% had decreased functional residual capacity; 52% experienced nocturnal desaturation.
- Snoring and respiratory event indices correlated with BMI Z-score and neck/height ratio.
Conclusions:
- Severely obese children frequently exhibit pulmonary function deficits and sleep-breathing issues.
- These respiratory problems are linked to impaired upper airway respiratory conductance.
Background & Aims:
To evaluate the frequency of pulmonary function and sleep-breathing disorders in severely obese children and to search for their association with obesity phenotypes.
Methods:
Sleep studies and spirometry were performed for 54 severely obese children.
Results:
Upper airway resistances (RAWs) were increased with RAW>200% and forced 25s expiratory volume<80% in 83% and 60% of individuals, respectively. A decrease in functional residual capacity (FRC)<80% was found in 43%. Fifty-two percent of the children had a desaturation index>10 during sleep, and 41% of children presented at least one of three severity criteria (snoring index>300 per hour, respiratory events index (REI)>10 and arousal index>10). Univariate analyses showed a positive correlation between snoring index and BMI Z-score and neck/height ratio (P=0.01 and 0.04, respectively) as between REI and the same parameters (P=0.01 and 0.03, respectively). In a multivariate model with BMI Z-score, NHR still correlated with the snoring index (P=0.02) and REI (P=0.01).
Conclusions:
In our cohort, obese children showed frequent pulmonary function and sleep-breathing disorders. The later were associated with impaired upper airway respiratory conductance.
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