BACKGROUND Pediatric obesity is closely associated with obstructive sleep apnea (OSA) and short sleep duration. While multidisciplinary weight loss interventions are recommended for pediatric obesity management, the evidence for their effects on OSA severity and overall sleep in youth have not been systematically examined. OBJECTIVES To conduct a systematic review and meta-analysis investigating the effects of multidisciplinary weight loss interventions on OSA severity and prevalence, and on overall sleep health in youth with obesity. METHODS A systematic search of interventional studies (participants age range: 10-19 yrs) was performed using PubMed, CENTRAL and Embase, from inception to May 2019. The quality of the evidence was assessed using the Cochrane risk of bias tool. RESULTS Ten studies were included by the end of the screening process. Ninety percent of the included studies reported a decrease in OSA prevalence post-intervention, and OSA was normalized for 46.2-79.7% of the youth. The meta-analysis comprising seven longitudinal studies revealed significant reductions in apnea-hypopnea index (effect size: -0.51, 95%CI -0.94 to -0.08, p = 0.019), and oxygen desaturation index (effect size: -0.28, 95%CI = -0.50 to -0.05, p = 0.016). Seventy-five percent of the studies reported improved sleep duration in youth with OSA. CONCLUSIONS Evidence suggests that multidisciplinary weight loss interventions result in improvements in OSA severity and sleep duration in youth with obesity. Future randomized controlled trials are warranted to better assess and understand the independent implications of weight loss, fat mass decrease and chronic exercise on OSA and sleep health in this population.

中文翻译：

---

阻塞性睡眠呼吸暂停和睡眠是否因肥胖青年的多学科减肥干预而得到改善？系统评价和荟萃分析。

背景 儿童肥胖与阻塞性睡眠呼吸暂停 (OSA) 和睡眠时间短密切相关。虽然建议将多学科减肥干预措施用于儿童肥胖管理，但尚未系统地研究其对 OSA 严重程度和整体睡眠影响的证据。目的 进行系统评价和荟萃分析，调查多学科减肥干预对 OSA 严重程度和患病率的影响，以及对肥胖青年整体睡眠健康的影响。方法 从开始到 2019 年 5 月，使用 PubMed、CENTRAL 和 Embase 对干预性研究（参与者年龄范围：10-19 岁）进行系统搜索。使用 Cochrane 偏倚风险工具评估证据质量。结果 筛选过程结束时纳入了 10 项研究。90% 的纳入研究报告干预后 OSA 患病率下降，46.2-79.7% 的年轻人 OSA 正常化。包含七项纵向研究的荟萃分析显示，呼吸暂停-低通气指数（效应量：-0.51，95%CI -0.94 至 -0.08，p = 0.019）和氧饱和度指数（效应量：-0.28，95%）显着降低CI = -0.50 到 -0.05，p = 0.016）。75% 的研究报告改善了 OSA 青年的睡眠时间。结论 有证据表明，多学科减肥干预可改善肥胖青年的 OSA 严重程度和睡眠时间。未来的随机对照试验有必要更好地评估和理解体重减轻的独立影响，