Current Knowledge/Study Rationale: In adults with obesity and sleep-disordered breathing (SDB), treatment with positive airway pressure (PAP) improves metabolic dysfunction, hypertension, and systemic inflammation. It is not known whether these conditions are already present at SDB diagnosis in youth or whether long-term PAP therapy improves markers of cardiometabolic disease in this population.
Study Impact: This study demonstrated that cardiometabolic disease (insulin resistance [HOMA-IR], hypertension, and systemic inflammation) is highly prevalent at the time of SDB diagnosis in youth with obesity. We were unable to detect statistically significant improvements in cardiometabolic markers 1 year after prescription of PAP therapy. There were, however, clinically relevant improvements in insulin resistance and systolic blood pressure load, important predictors of future risk of cardiovascular disease.