B61-13 Bariatric Surgery as Part of Severe Obstructive Sleep Apnea’s Treatment in an Adolescent With Morbid Obesity

Abstract Introduction The current and long-term health of 14.4 million children and adolescents is affected by obesity, making it one of the most common pediatric chronic diseases (1,2,3). Being overweight or obese increases the risk of developing sleep disorders such as obstructive sleep apnea (OSA) and having poor sleep as the result of OSA is associated with difficulty in controlling appetite, resulting in obesity (4). OSA is highly prevalent in obese patients and may contribute to cardiometabolic risk causing metabolic syndrome, diabetes and hypertension in the early stages of life (4,5). Weight loss is challenging due to lack of multispecialty programs, exercise programs and food insecurity. Most recent guidelines integrate advancements of pharmacotherapy and a more positive view toward bariatric surgery (BS) (1). This case is meant to highlight how addressing weight can have a positive impact in OSA and overall health. Case presentation A 17-year-old male with class 3 obesity (BMI=42.29kg/m2), prediabetes, fatty liver disease, hypertension and hypothyroidism underwent a PSG that showed OAHI 26.8/hour, SpO2 nadir 85% /mean 96% and normal CO2 levels. With prior tonsillectomy and adenectomy due to mild OSA (OAHI 4/hour) at age of 8 years, he was started on Auto CPAP (5 – 15 cm H20) with good compliance. He was followed by our Obesity Multispecialty clinic since the age of 10 years, but due to comorbidities and failure to lose weight patient underwent BS with a BMI 40 kg/m2, weight 106kg. A repeat sleep study was performed when he reached BMI 27 weight 76 kg which showed resolved OSA (OAHI= 2.7/hour SpO2 nadir 93%/mean 98% and normal CO2 levels). Patient has maintained BMI 30 kg/m2 two years after BS. Discussion and conclusion Leptin and ghrelin are two important hormones that help maintain energy balance. Leptin resistance has been identified as the major pathology leading to obesity (4). The prevalence of OSA in candidates for bariatric surgery varies between 35% and 94%. Weight loss achieved by BS is associated with significant long-term improvements in obstructive respiratory events, oxygenation and resolution of daytime somnolence (5, 6). This case highlights how OSA therapy is individualized and comprehensive. His OSA improved by addressing his comorbidities and not only starting CPAP. This abstract is funded by: None