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Effects of Obesity and Sex on Supine Functional Residual Capacity and Expiratory Flow Limitation in Children

Dharini M Bhammar1,2,3, Daniel P Wilhite3,4, Temitayo Olojo2,5

  • 1Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Pediatric Pulmonology
|April 15, 2025
PubMed

Insights

Children with obesity breathe at lower lung volumes when lying down, increasing their risk for expiratory flow limitation (EFL). Understanding these physiological changes can help manage sleep issues in obese children.

Area of Science:

  • Pediatric Pulmonology
  • Obesity Research
  • Sleep Medicine

Background:

  • Childhood obesity is linked to sleep-disordered breathing.
  • Physiologic mechanisms underlying this association require further investigation.

Purpose of the Study:

  • To examine the impact of obesity on lung volumes and expiratory flow limitation (EFL) in the supine position.
  • To assess respiratory symptoms in relation to obesity and posture.

Main Methods:

  • Compared lung volumes and EFL in 94 children (8-12 years) with and without obesity in seated and supine positions.
  • Simulated obesity in lean children using abdominal mass loading (2.3kg or 5.0kg).
  • Recorded ratings of perceived breathlessness (RPB).

Main Results:

  • Children with obesity exhibited significantly lower functional residual capacity (FRC) in the supine position compared to seated.
  • Expiratory flow limitation (EFL) was more prevalent in obese children when supine.
  • Abdominal mass loading in lean children reduced FRC and increased RPB, mimicking obesity effects.

Conclusions:

  • Obesity leads to reduced lung volumes in the supine position, elevating the risk of EFL in children.
  • A deeper understanding of obesity's mechanical effects is crucial for managing sleep-related symptoms in pediatric obesity.
Abstract

Keywords:
breathing limitationslung volumesorthopneapediatricposturesleep‐disordered breathing

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