More and more people are overweight or obese. This is becoming a huge global health concern. Recently, there have been numerous studies which have investigated the impact of obstructive sleep apnea on obesity, especially on childhood obesity. What’s more, obese children increase the risk of adult obesity. This condition is additionally complicated by obstructive sleep apnea. In fact, about 60% of obese children deal with obstructive sleep apnea. So, it’s very important to examine and have a closer look at these two conditions.

Obstructive Sleep Apnea in Children

Obstructive sleep apnea belongs to a set of conditions commonly known as sleep-disordered breathing. In children, obstructive sleep apnea happens when there is an absence of nasal airflow despite the presence of chest wall and abdominal wall movements. It lasts at least two breaths.

Obstructive sleep apnea is usually associated with sleep disruption, snoring, complete (apneas) obstruction of the upper airway, intermittent oxyhemoglobin desaturation, fragmentation, and recurrent partial (hypopneas). When it comes to snoring, only 1–3% of snoring children have obstructive sleep apnea.

Obstructive Sleep Apnea and Obesity

There are enough data which prove the strong connection between obstructive sleep apnea and obesity in children and adolescents. There have been two sets of observations regarding obstructive sleep apnea and obesity.

The first one is an observed commonness of obstructive sleep apnea in obese children and adolescents. Whereas, the second is a higher part of obese children who have obstructive sleep apnea. Both of these conditions are synchronous and impact each other.

In fact, about 60% of obese children and adolescents have obstructive sleep apnea. What’s more, the more severe obstructive sleep apnea is the severity of obesity increases.

Factors for Increased Risk of Obstructive Sleep Apnea in Obese Children and Adolescents

The risk of obstructive sleep apnea among obese children and adolescents depends on various factors. Among obese children, the main trigger for obstructive sleep apnea has proven to be an airway obstruction by adenotonsillar hypertrophy (ATH). Adenotonsillar hypertrophy in obese children might happen as a result of different distinct mechanisms, such as endocrine-mediated somatic growth.

Moreover, another factor which might increase the risk of obstructive sleep apnea in obese children is altered neuromuscular tone. The altered neuromuscular tone causes greater upper airway collapsibility during sleep. Furthermore, some of the additional factors for higher risk are central adiposity and an excess mechanical load on the chest wall.

Management of Obesity and Obstructive Sleep Apnea

It is crucial to treat both these conditions. There are various steps which obese children and adolescents should undertake and these include consuming meals at regular times and doing regular yet moderate physical exercise on a daily basis.

On the other hand, in order to treat obstructive sleep apnea, obese children are advised for adenotonsillectomy, an operation to remove both the adenoids and tonsils. This operating improves obstructive symptoms in 80% of cases.

One of the most useful and effective methods for treating both these conditions has become the Positive Airway Pressure (PAP) therapy. This therapy works best when combined with weight loss strategies. This therapy can either be administered as continuous PAP (CPAP) or the more physiological Bi-level PAP (BiPAP). It has been proven that children with obstructive sleep apnea benefit from PAP therapy.

Additionally, there are also other treatment options which can help obese children with obstructive sleep apnea. These include oral appliances and devices that expand the upper airway space. However, such devices are also beneficial for children or adolescents with mild sleep apnea.

In a nutshell, obstructive sleep apnea means that both adults and children deal with inadequate sleep quality and quantity. Various studies have proven that there is a strong connection between obstructive sleep apnea and obesity. In fact, obstructive sleep apnea significantly increases the risk of obesity. What’s more, it doesn’t only increase the risk but also worsens obesity with its direct impact.