Author(s)
Ajay Narayanan, BS
Romaine F Johnson, MD
Alexander Hansen, MD
Ahana Yogesh, BA
Gopi B Shah, MD MPH
Ron B. Mitchell, MD
Affiliation(s)
UT Southwestern Medical Center
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss the relationship between the velocity of weight gain and obstructive sleep apnea severity in obese adolescents. Objectives: To evaluate a cohort of obese adolescents with OSA to determine if those with severe OSA had increased yearly weight gain when compared to those without severe OSA. Study Design: A case control series. Methods: Adolescents, ages 12-17 years, referred for full night polysomnography (PSG) were analyzed. We examined demographics, weight classifications, yearly weight gain from age six onward, PSG data (apnea hypopnea index), tonsil size, asthma, GERD, and allergic rhinitis. We performed a mixed effect linear regression model to test whether the velocity of weight gain was more significant in obese patients with severe OSA when compared to those without severe OSA while controlling for possible confounding variables. Results: This study included 166 patients--105 were obese without severe OSA, and 61 were obese with severe OSA. The average age was 14 years and was predominately male (57%) or Hispanic (44%). The regression analysis found that the yearly change in weight among obese adolescents with severe OSA was significantly higher than those without severe OSA (B = 1.4, SE = 0.50, p = .005, 95% CI = 0.42 to 2.4). For the group with severe OSA, weight increased 6.5kg every year before their PSG. This finding held even after controlling for asthma, tonsillar hypertrophy, allergic rhinitis, or GERD. Conclusions: The results suggest that the rate of weight gain over time, in addition to the current weight, should be considered when evaluating for severe OSA in obese adolescents.