Detection and treatment of respiratory disorders in obese children: Obstructive sleep apnea syndrome and obesity hypoventilation syndrome

Pediatric obesity may induce multiple complications, including cardiovascular and metabolic problems in adulthood. It may also cause respiratory disorders, which are not usually the first-intention diagnosis by physicians. The aim of this study was to evaluate how investigations had been performed in obese children referred to Timone Pediatric Hospital. Patients and methods. A retrospective study of children referred to our department for severe non-syndromic obesity was conducted. The clinical features comprised history, anthropometric parameters, dietary habits, acanthosis nigricans, symptoms of obstructive sleep apnea syndrome (OSAS) as well as the paraclinical endocrine markers, blood gases, and sleep recordings. Results. Of 102 patients (mean age, 10.5 +/- 3.3 years; BMI Z-score, 4.52 +/- 1.5), 29.4% had OSAS symptoms (n =30). Nine had a pathological polysomnography confirming OSAS. Eight of them required ventilation: these children were the most severe with an earlier weight gain (2.17 +/- 1.2 years vs. 4.0 +/- 2.2 years; P=0.01) and a higher BMI Z-score (7.2 +/- 2.3 vs. 4.3 +/- 1.1; P=0.027). Obesity hypoventilation syndrome (OHS) was diagnosed in 3.9% of these. children (n =4). Conclusion. Diagnosis of OSAS and OHS, often overlooked in obese children, requires a systematic approach and early clinical detection of respiratory disorders. Better accessibility to sleep respiratory explorations would improve quality of care for these children. (C) 2015 Published by Elsevier Masson SAS.