Heated Humidified High Flow Nasal Cannula Oxygen in Obstructive Sleep Apnea in Adolescents

OBESE SUBJECTS: Inclusion Criteria: * Obesity, defined as a BMI \> 95th percentile for age and gender * Age 10 through 18 years * Informed consent with assent in accordance with the institutional policies (institutional IRB approval) must be signed by the patient's legally authorized guardian acknowledging written consent to join the study * Moderate-severe OSA or Central Sleep Apnea (CSA) as defined by OAHI or CAHI Exclusion Criteria: * Patients with other neurological problems, including but not limited to neurocutaneous disorders such as neurofibromatosis or tuberous sclerosis * Obesity due to other diseases and syndromes (e.g. Prader-Willi syndrome) * Pregnancy * Currently unwell, hospitalized or recent viral/bacterial infection in the previous 4 weeks * Adenoidal and/or tonsillar hypertrophy which may be amenable to surgical intervention to help alleviate OSA * Patients with severe respiratory distress * Patients with increased risk of pneumothorax including but not limited to previous pneumothorax, bronchiectasis or severe untreated asthma. CHILDREN WITH MEDICAL COMPLEXITY SUBJECTS: Inclusion Criteria: * CMC recently diagnosed with moderate to severe OSA or CSA requiring CPAP therapy * 0-18 years of age * Informed consent with assent in accordance with the institutional policies (institutional IRB approval) must be signed by the patient's legally authorized guardian acknowledging written consent to join the study Exclusion Criteria: * Current upper respiratory tract infection * Subjects who are receiving oxygen therapy