Introduction This study aimed to describe the cohort of obese children who were on respiratory support for obstructive sleep apnoea (OSA) or nocturnal hypoventilation in a tertiary respiratory centre and their adherence at 1 year.
Methods Clinical and cardiorespiratory polygraphy data were reviewed for children with a body mass index (BMI) >25kg/m2 established on NIV for OSA (AHI>1ev/Hr) or OHS (BMI>30kg/m2 and criteria for nocturnal hypoventilation)1 from 2013–21. Children with neuro-disability were excluded. Nocturnal hypoventilation was defined as transcutaneous carbon dioxide (TCO2) >6.7kPa ≥ 25% total sleep time (TST).1 Studies less than 4 hours TST were excluded. Day time hypercapnia was defined as TCO2 >5.99kPa ≥10 minutes.1 NIV compliance was >4 hours/night use for >70% of nights.2
Results Data was obtained from 16 children (9 males, 7 females) of whom 2 children had a BMI of 25-30kg/m2, and 14 > 30Kg/m2. Baseline polygraphy data was available on 13/16 children, 8 children had OSA only, 3 had OSA and nocturnal hypoventilation and 2 had and isolated OHS. 5 children (3M, 2F, age 9.0 (4.5-16) years) had nocturnal hypoventilation and also had the highest BMI of the cohort, BMI median 36.2 (28.6-47.3) kg/m2. Daytime hypercapnia was present in 4/9 children with measurements, but only 2 had nocturnal hypoventilation. No child had a TCO2 increase >10mmHg from wake to sleep. Children were established on NIV continuous (n=11) and bilevel (n=5). Only 2/14 children with adherence data were adherent to respiratory support at 1 year. (Table 1).
Discussion Assessment for complications of excess weight should include day and night-time TCO2 monitoring as OHS was evident from 5 years. Adherence to NIV is poor and intensive multi-disciplinary input may improve this.
Masa Eur Respir Rev 2019.
Schwab Am J Respir Crit Care Med 2013.
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