title: Obstructive sleep apnea in obese children and adolescents, treatment methods and outcome of treatment - A systematic review.
abstract: OBJECTIVE
  To systematically review and discuss the outcome of treating obstructive sleep apnea (OSA) in obese children and adolescents.
  
  
  METHODS
  In February 2016 Pub Med was searched using a predetermined string to retrieve all relevant articles. The search identified 518 publications. In total 16 articles were included for review using the selected inclusion and exclusion criteria. The PRISMA guidelines was used.
  
  
  RESULTS
  OSA was significantly more likely to persist in obese children after adenotonsillectomy. The prevalence of persistent OSA ranged from 33 to 76% in obese children and from 15 to 37% in non-obese children depending on the definition of OSA, the degree of obesity and the age of the study population. The few studies that investigated the effect of weight loss found that OSA improved significantly after intervention and that the prevalence of persistent OSA varied between 10 and 38%. Positive airway pressure was effective for treating OSA, but the mean nightly use was <4 h in two out of three available studies.
  
  
  CONCLUSIONS
  Obese children benefit less from adenotonsillectomy than normal-weight children. Weight loss improve OSA significantly, but more research is needed to clarify the role of weight loss as treatment for OSA. Positive airway pressure is effective for treating OSA; however, adherence is a challenge.
authors.affiliation: Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Lykkebækvej 1, 4600 Køge, Denmark; The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark. Electronic address: idga@regionsjaelland.dk.
authors.forename: Ida Gillberg
authors.initials: IG
authors.lastname: Andersen
authors.affiliation: The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Universitetsparken 1, 2200 Copenhagen, Denmark. Electronic address: jhom@regionsjaelland.dk.
authors.forename: Jens-Christian
authors.initials: JC
authors.lastname: Holm
authors.affiliation: Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Lykkebækvej 1, 4600 Køge, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark. Electronic address: prho@regionsjaelland.dk.
authors.forename: Preben
authors.initials: P
authors.lastname: Homøe
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D050110:Bariatric Surgery; D015992:Body Mass Index; D002648:Child; D045422:Continuous Positive Airway Pressure; D006801:Humans; D009765:Obesity / Q000150:complications / Q000628:therapy*; D010349:Patient Compliance; D017286:Polysomnography; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D014068:Tonsillectomy; D016896:Treatment Outcome; D061217:Weight Reduction Programs
keywords: Adenotonsillectomy; Children; Obesity; Obstructive sleep apnea; Positive airway pressure; Weight loss