Abstract
Objective: To test the effect of a long-term weight loss rehabilitation program in extremely obese adolescents on breathing parameters during sleep. Methods: Thirty-eight extremely obese [mean body mass index (BMI) 45.3 ± 7.9kg/m2] adolescents participated during a three- to nine-month period in an inpatient weight loss rehabilitation in a specialized long-term rehabilitation center. Breathing parameters were registered via a seven-channel portable screening device. Body weight and arterial blood pressure were measured before and after the long-term treatment. Results: Mean BMI decreased from 45.3 to 35.8 (p < 0.001), mean diastolic blood pressure decreased from 89 mmHg to 81 mmHg (p = 0,002). Nine patients had a RDI of ≥5 and 30 patients a RDI of <5; the mean RDI decreased from 4.08 to 3.27 (n.s.). Within the group, the RDI was ≥5 and the mean RDI decreased from 10.3/h to 5.2/h (p = 0.02). The mean SaO2 increased from 93.65 to 95.35% (p = 0.003), lowest SaO2 increased from 72.14 to 73.19% (n.s.) and snoring frequency decreased from 37.56% of total sleep time (TST) to 32.86% of TST (n.s.). Conclusion: A long-term inpatient weight loss program has a positive effect on breathing parameters during sleep in extremely obese adolescents. However, the effect on apneic events and snoring is relatively minor compared to the effect on arterial oxygen saturation. The role of obesity in the origin of respiratory events and snoring in adolescents might be overestimated.
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Redline S, Tishler PV, Hans MG, et al. Racial differences in sleep-disordered breathing in African-Americans and Caucasians. AM J Respir Crit Care Med 1997;155:186–192
Redline S, Tishler PV, Schluchter M, et al. Risk factors for sleep-disordered breathing in children. Associations with obesity, race and respiratory problems. AM J Respir Crit Care Med. 1999;159:1527–1532
Hochban W, Hoch B. Obstructive sleep apnea in the child: An interdisciplinary treatment concept with special reference to craniofacial changes. Pneumologie 1998;52:147–153
Johns FR, Strohlo PJ, Buckley M, Constantino J. The influence of craniofacial structure on obstructive sleep apnea in young adults. J Oral Maxillofac Surg 1998;56:596–602
Chin K, Ohi M. Obesity and obstructive sleep apnea syndrome. Intern Med 1999;38:200–202
Miro Castillo N, Rocas-Ribas Serda F, Quesada Martinez JL, Perello Scherdel E. Morphological comparative imaging of the pharynx in patients with obstructive sleep apnea syndrome (OSAS), healthy snores and controls. Acta Otorhinolaringol Esp 1998;49:34–40
Lonergan RP IIIrd, Ware JC, Atkinson RL, Winter WC, Suratt PM. Sleep apnea in obese miniature pigs. J Appl Physiol 1998;84:531–6
Rollheim J, Osnes T, Miljeteig H. The relationship between obstructive sleep apnoea and body mass index. Clin Otolaryngol 1997;22:419–422
Kuhl W. History of clinical research on the sleep apnea syndrome. The early days of polysomnography. Respiration 1997;64 Suppl 1:5–10
Brander PE, Mortimore IL, Douglas NJ. Effect of obesity and erect/supine posture on lateral cephalometry: Relationship to sleep disordered breathing. Eur Respir J 1999;13:398–402
Slyper AH. Childhood obesity, adipose tissue distribution and the pediatric practitioner. Pediatrics 1998;102:e4
Guilleminault C, Pelayo R. Sleep disordered breathing in children. Ann Med 1998;30:350–356
Kansanen M, Vanninen E, Tuunainen A, et al. The effect of a very low-calorie diet-induced weight loss on the severity of obstructive sleep apnoea and autonomic nervous function in obese patients with obstructive sleep apnoea syndrome. Clin Physiol 1998;18:377–385
Lojander J, Mustajoki P, Ronka S, Mecklin P, Maasilta P. A nurse managed weight reduction program for obstructive sleep apnoea syndrome. J Intern Med 1998;244:251–255
Sampol G, Munoz X, Sagales MT, et al. Long-term efficacy of dietary weight loss in sleep apnoea/hypopnoea syndrome. Eur Respir J 1998;12:1156–1159
Stradling J, Roberts D, Wilson A, Lovelock F. Controlled trial of hypnotherapy for weight loss in patients with obstructive sleep apnoea. Int J Obes Relat Metab Disord 1998;22:278–281
Coppola MP. Fat and prejudice. Sleep and Breathing 1999;3:35–36
Sakakibara H, Tong M, Matsushita K, et al. Cephhalometric abnormalities in non-obese and obese patients with obstructive sleep apnoea. Eur Respir J 1999;13:403–410
Dostalova S, Smahel Z, Sonka K. Craniofacial abnormalities in sleep apnoea syndrome. Acta Chir Plast 1998;40:49–53
Redline S, Tishler PV, Tosteson TD, et al. The familial aggregation of obstructive sleep apnea. AM J Respir Crit Care Med 1995;151:682–687
Kushida CA, Efron B, Guilleminault C. A predictive morphometric model for the obstructive sleep apnea syndrome. Ann Intern Med 1997;127:581–587
Cistulli PA. Craniofacial abnormalities in obstructive sleep apnoea: Implications for treatment. Respirology 1996;1(3):167–174
Mortimore IL, Marshall I, Wraith PK, Sellar RJ, Douglas NJ. Neck and total body fat deposition in nonobese and obese patients with sleep apnea compared with that in control subjects. AM J Respir Crit Care Med 1998;157:280–283
Redline S, Leitner J, Arnold J, Tishler PV, Altose MD. Ventilatory-control abnormalities in familial sleep apnea. AM J Respir Crit Care Med 1997;156:155–160
Soultan Z, Wadowski S, Rao M, Kravath RE. Effect of treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy on obesity in children. Arch Pediatr Adolesc Med 1999;153:33–37
Miro Castillo N, Roca-Ribas Serda F, Perello Scherdel E. Comparative cephalometric study in patients with obstructive sleep apnea syndrome (OSAS), simple snorers and controls. Acta Otorhinolaringol Esp 1998;49:111–118
Netzer N, Lormes W, Giebelhaus V, et al. Physical excercise in patients with sleep apnoea syndrome. Pneumologie 1997;51:779–782
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Siegfried, W., Siegfried, A., Rabenbauer, M. et al. Snoring and Sleep Apnea in Obese Adolescents: Effect of Long-term Weight Loss-Rehabilitation. Sleep Breath 3, 83–87 (1999). https://doi.org/10.1007/s11325-999-0083-7
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DOI: https://doi.org/10.1007/s11325-999-0083-7