Obstructive sleep-related breathing disorders in overweight and obese adolescents

Mariana Lopes-Costa, Centro Hospitalar de Leiria, EPE, Leiria, Portugal
Sofia Ferreira, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra. Portugal
Raquel Soares, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Núria Madureira, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

Introduction and Objectives: The causes behind obstructive sleep-related breathing disorders (OSRBD) are multifactorial, with obesity playing a significant role. Approximately 60% of obese children experience OSRBD. This study aims to characterize the severity of OSRBD in overweight or obese adolescents undergoing polysomnography (PSG) in a tertiary-level hospital. Methods: This retrospective descriptive study analyzed clinical records and PSG parameters of overweight or obese adolescents referred for PSG between 2016 and 2021. Adolescents with neuromuscular, genetic, or syndromic pathologies were excluded. Results: Sixty-seven overweight/obese adolescents were included, with 67% being males. Clinical manifestations of OSRBD included snoring in 94%, apneas in 70%, and daytime symptoms (excessive somnolence, headaches, and low school performance) in 76%. The median age at PSG was 14 years old. OSRBD was found in 75% of adolescents, with 16% experiencing moderate to severe obstructive sleep apnea syndrome. Notably, three of these adolescents were asymptomatic. Approximately 27% of the adolescents studied had an indication for non-invasive ventilation (NIV). Out of those who were followed up for at least twelve months after starting NIV (9/18), 56% exhibited good adherence. Conclusions: In our study, the prevalence of OSRBD was higher than described in the literature, albeit in a selected sample. The presence of OSRBD in three asymptomatic adolescents underscores the necessity of PSG, even in asymptomatic patients. NIV is a frequently chosen treatment, with challenges regarding long-term adherence in these patients.

Keywords: Adolescent obesity. Non-invasive ventilation. Obstructive sleep apnea syndrome.