Related Experiment Video
Updated: Aug 8, 2026
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Follow-up on metabolic markers in children treated for obstructive sleep apnea
Karen A Waters1, Sinthu Sitha, Louise M O'brien
1Kosair Children's Hospital Research Institute, Department of Pediatrics, University of Louisville, Louisville, Kentucky, USA. kaw@med.usyd.edu.au
Insights
Obesity is the main driver of metabolic issues in children with obstructive sleep apnea (OSA). However, resolving OSA may improve metabolic function over time, suggesting a link between OSA treatment and metabolic health in pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Sleep Medicine
- Metabolic Health
Background:
- Obstructive sleep apnea (OSA) in adults is linked to metabolic dysfunction that improves with treatment.
- No studies have investigated this relationship in children.
- Understanding this connection in pediatric populations is crucial for early intervention.
Purpose of the Study:
- To investigate the relationship between metabolic markers and obstructive sleep apnea (OSA) in children.
- To assess how these markers change over time with OSA treatment.
- To identify factors influencing metabolic dysfunction in pediatric OSA.
Main Methods:
- Metabolic markers were measured via fasting blood samples during diagnostic polysomnography.
- Follow-up assessments were conducted approximately 1.3 years later.
- Children were analyzed based on OSA status, obesity, and treatment (surgical or no treatment).
Main Results:
- No significant differences in metabolic markers were found between children with and without OSA at initial study.
- Obese children exhibited higher insulin and insulin/glucose ratio, and lower HDL cholesterol compared to nonobese children.
- Resolution of OSA correlated with improved total cholesterol, and persisting OSA in obese children showed a trend toward elevated insulin.
Conclusions:
- Obesity is identified as the primary factor influencing metabolic dysfunction in children with OSA.
- Preliminary findings suggest that the resolution or persistence of OSA may impact metabolic function changes over time.
- Further research is warranted to confirm the long-term effects of OSA on pediatric metabolic health.
Rationale:
In adults, obstructive sleep apnea (OSA) is associated with metabolic dysfunction that improves with treatment of OSA. No equivalent studies exist in children.
Objective:
To examine the relationship between metabolic markers and OSA with time and treatment in children.
Methods:
Metabolic markers measured on a fasting morning blood sample at diagnostic polysomnography and follow-up 1.3 +/- 0.6 yr later.
Measurements And Main Results:
Forty-five children (34 males), aged 6.9 +/- 3.5 yr, and including 12 obese subjects, were in the final analysis. There were no differences in metabolic markers between children with and without OSA at initial study; however, obese children had significantly higher insulin (106.1 +/- 72.1 vs. 66.7 +/- 37.6 pmol/L; p = 0.028), insulin/glucose ratio (23.7 +/- 14.3 vs. 14.7 +/- 8.0; p = 0.02), and significantly lower high-density lipoprotein cholesterol (1.3 +/- 0.2 vs. 1.6 +/- 0.4 nmol/L; p = 0.005) than nonobese children. Twenty children underwent surgical removal of adenotonsillar tissue, whereas 12 children with OSA elected not to have treatment. OSA persisted after treatment in five children, and resolved in 27. Thirteen children did not have OSA on initial or follow-up studies. At follow-up, there was a small but significant improvement in total cholesterol in those children whose OSA was resolved (4.8 +/- 0.8 to 4.7 +/- 0.6 nmol/L; p = 0.005) and a trend for obese children with persisting OSA to have elevated insulin levels compared with obese children without OSA (p = 0.07).
Conclusion:
Obesity appears to be the major influence on metabolic dysfunction in children with OSA, but these preliminary data also suggest that resolution or persistence of OSA may affect changes in metabolic function over time.
