Weight loss effective for sleep-disordered breathing in obese adolescents
Weight loss is a viable treatment for sleep-disordered breathing (SDB) in obese adolescents, a recent study has found. However, more severe SDB and respiratory allergies at baseline increase the risk of residual SDB even after weight loss.
Following weight loss treatment and a 32-percent mean decrease in body mass index (BMI) z score, only 16 of the 79 participants with baseline SDB showed residual sleep apnoea. The resulting treatment success rate was 80 percent.
Baseline allergies were significantly more common in those with vs without residual SDB (42.9 percent vs 14.0 percent; p=0.03). In addition, median oxygen desaturation index values were significantly lower in those whose breathing patterns during sleep had normalized (5.52 vs 2.90 events/hour; p=0.002), indicating a less severe condition at baseline.
Other measures of disease severity, such as the apnoea-hypopnoea index (3.78 vs 2.56 events/hour; p=0.05), mean oxygen saturation (SaO2; 95 percent vs 97 percent; p=0.009) and SaO2 nadir (84 percent vs 89 percent; p=0.002) were significantly worse in those who had residual SDB.
“Our results show that weight loss is a better first-line alternative for treating SDB in an obese adolescent patient,” said researchers, however noting that future studies on the role of airway inflammation on residual sleep apnoea may result in potential pharmacologic treatment options in combination with conventional weight loss.
The study included 339 obese adolescent patients (median age 15.4 years; 35 percent male; mean baseline BMI z score, 2.75±0.42). The weight loss program included moderate dietary restrictions, psychological support, medical supervision and increased physical activity.