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Pediatrics

Are obstructive sleep apnea and sleep improved in response to multidisciplinary weight loss interventions in youth with obesity? A systematic review and meta-analysis

International Journal of Obesity volume 44, pages 753–770 (2020)Cite this article

Subjects

Abstract

Background

Pediatric obesity is closely associated with obstructive sleep apnea (OSA) and short sleep duration. While multidisciplinary weight loss interventions are recommended for pediatric obesity management, the evidence for their effects on OSA severity and overall sleep in youth have not been systematically examined.

Objectives

To conduct a systematic review and meta-analysis investigating the effects of multidisciplinary weight loss interventions on OSA severity and prevalence, and on overall sleep health in youth with obesity.

Methods

A systematic search of interventional studies (participants age range: 10–19 yrs) was performed using PubMed, CENTRAL and Embase, from inception to May 2019. The quality of the evidence was assessed using the Cochrane risk of bias tool.

Results

Ten studies were included by the end of the screening process. Ninety percent of the included studies reported a decrease in OSA prevalence post-intervention, and OSA was normalized for 46.2–79.7% of the youth. The meta-analysis comprising seven longitudinal studies revealed significant reductions in apnea–hypopnea index (effect size: −0.51, 95%CI −0.94 to −0.08, p = 0.019), and oxygen desaturation index (effect size: −0.28, 95%CI = −0.50 to −0.05, p = 0.016). Seventy-five percent of the studies reported improved sleep duration in youth with OSA.

Conclusions

Evidence suggests that multidisciplinary weight loss interventions result in improvements in OSA severity and sleep duration in youth with obesity. Future randomized controlled trials are warranted to better assess and understand the independent implications of weight loss, fat mass decrease and chronic exercise on OSA and sleep health in this population.

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Acknowledgements

The authors would like to address particular words of thanks to Nathalie Piñol-Domenech and Catherine Weill for their precious help for the database search and search combinations determination, and to Dr Karine Scheuermaier for scientific output.

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Authors and Affiliations

  1. Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, EA, 3533, France

    Johanna Roche & David Thivel

  2. Exercise Performance Health Innovation platform, University of Franche-Comte, Besançon, EA, 3920, France

    Johanna Roche, Laurie Isacco & Fabienne Mougin

  3. Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Johanna Roche

  4. UGECAM Nutrition Obesity Ambulatory Hospital, Clermont-Ferrand, France

    Julie Masurier

  5. Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France

    Bruno Pereira

  6. Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada

    Jean-Philippe Chaput

  7. Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    Jean-Philippe Chaput

  8. Auvergne Research Center for Human Nutrition (CRNH), Clermont-Ferrand, France

    David Thivel

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Roche, J., Isacco, L., Masurier, J. et al. Are obstructive sleep apnea and sleep improved in response to multidisciplinary weight loss interventions in youth with obesity? A systematic review and meta-analysis. Int J Obes 44, 753–770 (2020). https://doi.org/10.1038/s41366-019-0497-7

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