Sleep Disorders |

Evaluation of Sleep-Disordered Breathing in Morbidly Obese Adolescents Seeking Bariatric Surgery FREE TO VIEW

Abigail Strang, MD; Thao-Ly Phan, MD; George Datto, MD; Aaron Chidekel, MD
Author and Funding Information

A.I. duPont Hospital for Children, Wilmington, DE

Chest. 2013;144(4_MeetingAbstracts):985A. doi:10.1378/chest.1703557
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SESSION TITLE: Sleep Disorders I

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 29, 2013 at 02:45 PM - 04:15 PM

PURPOSE: Bariatric surgery is becoming increasingly utilized as a treatment for morbid obesity in adolescents. Sleep-disordered breathing (SDB) carries significant perioperative risks. Therefore, the objective of this study was to evaluate respiratory sleep parameters in a cohort of morbidly obese adolescents seeking bariatric surgery.

METHODS: This cross-sectional analysis was conducted using baseline polysomnograms of 45 morbidly obese adolescents (mean age 16.4 years, 84% female, 53% Caucasian, mean BMI 52.1 kg/m2, and mean neck circumference [NC] 39.0 cm) enrolled from 2007 to 2012 in an FDA-approved study of the LAP-BAND® Adjustable Gastric-Banding System. Studies were conducted in the same AASM-accredited sleep laboratory. Descriptive statistics were calculated to characterize the respiratory parameters. SDB was defined as an obstructive apnea index (OAI) or apnea-hypopnea index (AHI) >1 event/hr, SpO2-nadir <92%, ETCO2 peak >53 mmHg, or total sleep time (TST) >10% with ETC02 >50 mmHg. Moderate-severe SDB was defined as OAI or AHI >5 events/hr, SpO2-nadir <86%, ETCO2 peak >60 mmHg, or TST >25% with ETCO2 >50 mmHg. Pearson’s correlation coefficient and t-tests were calculated to measure the association between demographic and anthropometric variables and respiratory sleep parameters.

RESULTS: Overall, 82% of patients in the study demonstrated SDB; 42% demonstrated moderate-severe SDB in at least one category. Mean OAI was 1.1(±4.2) events/hr. Mean AHI was 5.2(±9.5) events/hr. Average SpO2-nadir was 90.7(±5.1)%. Mean peak ETCO2 was 53.6(±6.9) mmHg, and mean percentage of TST above 50 mmHg was 19.8(±33.5)%. OAI was worse in males than females by 4.1 events/hr (p<0.05). BMI was associated with AHI (r= 0.34, p<0.05). NC was associated with OAI (r= 0.35, p<0.05) and AHI (r= 0.35, p<0.05).

CONCLUSIONS: The majority of morbidly obese adolescents demonstrated SDB, with almost half showing moderate-severe SDB. Male gender, BMI and NC were associated with SDB.

CLINICAL IMPLICATIONS: SDB is prevalent in morbidly obese adolescents seeking bariatric surgery. Formal evaluation of sleep is important to minimize perioperative risks in these patients.

DISCLOSURE: The following authors have nothing to disclose: Abigail Strang, Thao-Ly Phan, George Datto, Aaron Chidekel

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