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Positive Airway Pressure and Metabolic Markers in Children With Obstructive Sleep Apnea

Christopher A Gerdung1, Daniel B Ofosu1, Sara Rodriguez-Lopez1

  • 1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

Respiratory Care
|April 23, 2024
PubMed

Insights

Positive airway pressure (PAP) shows some benefits for children with obstructive sleep apnea (OSA), reducing heart rate and blood pressure. However, effects on body mass index and other metabolic markers are limited, requiring more research.

Area of Science:

  • Pediatric Sleep Medicine
  • Metabolic Health
  • Cardiovascular Physiology

Background:

  • Childhood obstructive sleep apnea (OSA) is increasingly linked to metabolic syndrome.
  • Research on positive airway pressure (PAP) effects on pediatric metabolic markers is growing.

Purpose of the Study:

  • To systematically review and synthesize evidence on PAP's impact on metabolic markers in children with OSA.

Main Methods:

  • Systematic search of 5 databases (until August 2022) using terms for OSA and pediatric metabolic markers.
  • Inclusion of 16 studies (15 observational, 1 RCT) with meta-analysis of 4 studies.
  • Assessment of body mass index (BMI), glycemic, lipid, cardiovascular, and inflammatory markers.

Main Results:

  • No significant changes in BMI were observed after PAP initiation (median follow-up 12 months).
  • Reductions in heart rate and blood pressure were noted (median follow-up 4.9 months).
  • Limited and clinically insignificant evidence for improvements in glycemic/lipid control, liver enzymes, or inflammatory markers; very low outcome evidence.

Conclusions:

  • Evidence for PAP's metabolic benefits in pediatric OSA is encouraging but limited.
  • Further longitudinal studies are needed to assess long-term effects, especially in children with obesity.
Abstract

Keywords:
body mass indexchildmetabolic markersobstructive sleep apneapediatricspositive airway pressure

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