Antics Dorottya, Kelemen Judit N, Muzslay Eszter, Lendvai Zsófia, Valkó Luca, Baglyas Szabolcs, Hérák Benjámin J, Luczay Andrea, Szabó Attila J, Czövek Dorottya
Semmelweis University Pediatric Center, MTA Center of Excellence, Bókay János street 53-54, 1083, Budapest, Hungary; Semmelweis University Doctoral School, Üllői street 26, 1085, Budapest, Hungary.
Semmelweis University Pediatric Center, MTA Center of Excellence, Bókay János street 53-54, 1083, Budapest, Hungary.
Sleep Med. 2025 Oct;134:106748. doi: 10.1016/j.sleep.2025.106748. Epub 2025 Aug 16.
Sleep-disordered breathing (SDB) is an increasingly recognized co-morbidity in childhood obesity. SDB may contribute to the excessive weight gain; however, diagnosis and treatment strategies are not well-defined during childhood. Most pediatric studies focus solely on obstructive sleep apnea (OSA), although hypoventilation may play a separate but pivotal role in the course of the condition. This study aimed to explore the role of transcutaneous carbon-dioxide monitoring (tcCO) as a part of the polysomnographic assessment (PSG) in identifying nocturnal hypoventilation and non-invasive ventilation (NIV) need for overweight and obese children with SDB.
In this retrospective study clinical, PSG and tcCO data of children with overweight and obesity (BMI Z-score ≥1; 5-18 yrs) were collected between 2021 and 2024. PSG recordings, including tcCO2 monitoring, were analyzed according to current guideline. The frequency of OSA, nocturnal hypoventilation and obesity hypoventilation syndrome (OHS), along with the need for long-term NIV treatment were determined.
Out of 41 children involved, sixteen (39 %) had mild, seven (17 %) had moderate and ten (24 %) had severe OSA. Twenty-three children met the criteria for nocturnal hypoventilation. In four patients hypoventilation was present without OSA. Seventeen children were diagnosed with OHS; NIV was initiated in 18 children.
SDB is a possible consequence of childhood obesity and hypoventilation can be present without OSA. As our results suggest, concurrent continuous monitoring of tcCO can identify hypoventilation, which can be present without severe OSA. TcCO-assisted polysomnography may be essential for identifying the need for NIV and for preventing adverse outcomes.
睡眠呼吸紊乱（SDB）是儿童肥胖中一种日益被认识到的合并症。SDB可能导致体重过度增加；然而，儿童期的诊断和治疗策略尚未明确。大多数儿科研究仅关注阻塞性睡眠呼吸暂停（OSA），尽管通气不足在该病症过程中可能起独立但关键的作用。本研究旨在探讨经皮二氧化碳监测（tcCO）作为多导睡眠图评估（PSG）的一部分，在识别患有SDB的超重和肥胖儿童夜间通气不足及无创通气（NIV）需求方面的作用。
在这项回顾性研究中，收集了2021年至2024年间超重和肥胖儿童（BMI Z评分≥1；5 - 18岁）的临床、PSG和tcCO数据。根据当前指南分析包括tcCO2监测在内的PSG记录。确定OSA、夜间通气不足和肥胖通气不足综合征（OHS）的发生率，以及长期NIV治疗的需求。
在纳入的41名儿童中，16名（39%）患有轻度OSA，7名（17%）患有中度OSA，10名（24%）患有重度OSA。23名儿童符合夜间通气不足标准。4名患者存在通气不足但无OSA。17名儿童被诊断为OHS；18名儿童开始接受NIV治疗。
SDB是儿童肥胖的一个可能后果，通气不足可在无OSA的情况下出现。正如我们的结果所示，同时连续监测tcCO可识别通气不足，其可在无严重OSA的情况下出现。TcCO辅助的多导睡眠图检查对于确定NIV需求和预防不良后果可能至关重要。
