Characteristics and surgical and clinical outcomes of severely obese children with obstructive sleep apnea

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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

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Gulnur Com1, John L Carroll1, Xinyu Tang2

  • 1Department of Pediatrics, Division of Pediatric Pulmonology and Sleep Medicine, University of Arkansas Medical Sciences, Little Rock, AR.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|February 11, 2015
PubMed

Insights

Surgery improved polysomnography indices for most obese children with obstructive sleep apnea (OSA). While not all were cured, many experienced significant improvements in their AHI and other key metrics.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Obesity

Background:

  • Obstructive sleep apnea (OSA) is a significant concern in obese children.
  • Understanding surgical outcomes is crucial for managing pediatric OSA.

Purpose of the Study:

  • To characterize obese children diagnosed with OSA.
  • To evaluate surgical and clinical outcomes following interventions for OSA in this population.

Main Methods:

  • Retrospective review of 143 obese children with OSA diagnosed via polysomnography (OPSG) between 2000-2010.
  • Analysis of demographics, clinical findings, and OSA severity.
  • Comparison of pre- and post-surgery OPSG indices, including apneahypopnea index (AHI), with definition of cure as AHI < 1.5/h.

Main Results:

  • Of 143 children, 78 underwent surgery. Adenotonsillectomy (AT) was the most common procedure.
  • Surgery improved OPSG indices in the majority (p = 0.001), with a 26% cure rate.
  • Adenotonsillectomy (AT) was the only surgery significantly reducing AHI (p = 0.008). Enlarged tonsils and no prior surgery predicted better outcomes.
  • No significant weight loss was observed, and adherence to positive airway pressure (PAP) therapy was poor.

Conclusions:

  • Surgical interventions generally improve OPSG indices in obese children with OSA.
  • Specific procedures like AT show significant AHI reduction.
  • Further strategies are needed to address weight management and PAP adherence in this cohort.
Abstract

Keywords:
adenotonsillectomychildrenobesitypositive airway pressure treatmentsleep apneauvulopharyngopalatoplasty

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