Impact of OSA Treatment Success on Changes in Hypertension and Obesity: A Retrospective Cohort Study

Abstract

Objective: Pediatric obstructive sleep apnea (OSA) has been shown to lead to the development of chronic cardiometabolic conditions, including obesity and cardiovascular disease. We sought to describe the impact of the success of continuous positive airway pressure (CPAP) and surgery, common treatment options for pediatric OSA, on cardiometabolic conditions. Methods: A retrospective review of patients (≤18 years) diagnosed with OSA based on a polysomnogram at a tertiary care pediatric otolaryngology practice from 2015 to 2019 was conducted. Clinical data, including the systolic blood pressure (SBP) values, body mass index (BMI), overall apnea/hypopnea index (AHI) values, and CPAP compliance, were collected. Linear mixed-effects models were developed to observe the relationship between the clinical measurements of each comorbidity and OSA treatment modalities. Results: 507 patients were included. BMI and SBP measures were collected for 230 and 277 patients respectively. The difference-in-difference estimate for the SBP z-score percentile after successful treatment was -5.3 +/- 2.0 percentile units per 100 days. The difference-in-difference estimate for SBP z-score percentile after successful CPAP treatment was -14.4 +/- 4.9 percentile units per 100 days while the estimate after successful surgical treatment was -4.6 +/- 2.3 percentile units per 100 days. No significant differences were found between clinical measures for obese patients in any treatment cohort. Conclusions: The success of OSA management was shown to have a positive impact on SBP in hypertensive patients and no impact on BMI in obese patients. In hypertensive patients, CPAP success tripled improvements in SBP z-score percentile compared to surgical treatment success.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Childrens Healthcare of Atlanta Institutional Review Board gave ethical approval for this work.

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Yes

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Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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