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Pediatric Obstructive Sleep Apnea

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https://www.readbyqxmd.com/read/27908527/-historical-review-on-obstructive-sleep-apnea-in-children
#1
Y H Chien, C Guilleminault
An historical review on the discoveries on pediatric obstructive sleep apnea syndrome and sleep-disordered breathing is outlined. Starting with the description by Dickens of "Joe" the obese, snoring and sleepy individual, the authors trace more than 50 years of questions and research starting with the lean adult to the child and from the recognition of obstructive sleep apnea syndrome to the outline of upper-airway resistance syndrome. The pathophysiological knowledge on sleep-disordered breathing has evolved over time, as have treatment approaches in children, from tracheostomy to positive-airway-pressure therapy, to adenotonsillectomy with and without orthodontic treatments to oral-facial myofunctional therapy...
November 28, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27890604/gender-dimorphism-in-pediatric-osa-is-it-for-real
#2
REVIEW
Pablo E Brockmann, Dorit Koren, Leila Kheirandish-Gozal, David Gozal
In epidemiologic studies focused on adults, obstructive sleep apnea (OSA) has higher prevalence in men than in women. The evidence supporting a gender-related discrepant prevalence of OSA is however much more tenuous in children. Here, we aimed to review the evidence concerning gender- based differences in the prevalence of OSA in children, and if so, to examine the evidence with the intent to identify potential factors that may account for this putative association. Gender-based perception and reporting of clinical manifestations of OSA may be modulated by several social and cultural factors in children...
November 23, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27876406/adenotonsillectomy-can-decrease-enuresis-and-sympathetic-nervous-activity-in-children-with-obstructive-sleep-apnea-syndrome
#3
Hao Ding, Mengmei Wang, Ke Hu, Jing Kang, Si Tang, Wen Lu, Lifang Xu
BACKGROUND: The nocturnal intermittent hypoxia caused by obstructive sleep apnea syndrome (OSAS) can provoke the sympathetic nervous activity (SNA). Salivary alpha-amylase (sAA) is a sensitive, non-invasive biomarker for reflecting the SNA, and a useful marker for pediatric OSAS subjects. Adenotonsillar hypertrophy (ATH) is the most commonly identified risk factor in OSAS childhood, therefore, several studies showed that the adenotonsillectomy (T&A) may alleviate nocturnal enuresis (NE) in children with OSAS...
November 9, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27865065/how-do-we-recognize-the-child-with-osas
#4
Koen F Joosten, Helena Larramona, Silvia Miano, Dick Van Waardenburg, Athanasios G Kaditis, Nele Vandenbussche, Refika Ersu
Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e...
November 16, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27863643/the-safety-and-efficacy-of-pediatric-lingual-tonsillectomy
#5
M A DeMarcantonio, E Senser, J Meinzen-Derr, N Roetting, S Shott, S L Ishman
OBJECTIVE: Lingual tonsillar hypertrophy is recognized as a cause of persistent obstructive sleep apnea (OSA) after adenotonsillectomy in children. However, little has been reported regarding the complications, postoperative course and effectiveness of lingual tonsillectomy (LT). Our objective was to review the safety and effectiveness of LT in children. METHODS: Retrospective review of children undergoing LT from January 2009 to December 2015 at a tertiary children's hospital...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27863630/comparison-of-treatment-outcomes-between-intracapsular-and-total-tonsillectomy-for-pediatric-obstructive-sleep-apnea
#6
David T Chang, Allison Zemek, Peter J Koltai
BACKGROUND: Intracapsular tonsillectomy (IT) has been advocated as a treatment for pediatric obstructive sleep apnea (OSA). However, evidence in the literature utilizing polysomnography (PSG) is limited. OBJECTIVE: To examine the experience at a tertiary children's hospital to evaluate the effectiveness and risks of intracapsular tonsillectomy compared to total tonsillectomy (TT) for treating pediatric OSA. METHODS: A retrospective study was undertaken of pediatric tonsillectomy cases performed for OSA at a tertiary children's hospital from 2005 to 2010...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27855751/financial-analysis-of-an-intensive-pediatric-continuous-positive-airway-pressure-program
#7
E Brooks Riley, Evan S Fieldston, Melissa S Xanthopoulos, Suzanne E Beck, Mary Kate Menello, Edward Matthews, Carole L Marcus
STUDY OBJECTIVES: Continuous positive airway pressure (CPAP) is effective in treating obstructive sleep apnea in children, but adherence to therapy is low. Our center created an intensive program that aimed to improve adherence. Our objective was to estimate the program's efficacy, cost, revenue and break-even point in a generalizable manner relative to a standard approach. METHODS: The intensive program included device consignment, behavioral psychology counseling and follow-up telephone calls...
November 14, 2016: Sleep
https://www.readbyqxmd.com/read/27855739/validation-of-polyvinylidene-fluoride-impedance-sensor-for-respiratory-event-classification-during-polysomnography-in-children
#8
Anne G Griffiths, Pallavi P Patwari, Darius A Loghmanee, Matthew J Balog, Irina Trosman, Stephen H Sheldon
STUDY OBJECTIVES: Polysomnography is the gold standard for diagnosis and characterization of severity of sleep-disordered breathing. Accuracy and reliability of the technology used are critical to the integrity of the study's interpretation. Strict criteria for obstructive sleep apnea in children are lacking and diagnosis often requires consideration of both frequency of respiratory events in addition to other measures. Current American Academy of Sleep Medicine recommendations for pediatric patients includes use of respiratory inductance plethysmography (RIP) belts, whereas polyvinylidene fluoride (PVDF) belts are currently only acceptable for use in adults...
November 14, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27833988/tonsillar-lymphoma-masquerading-as-obstructive-sleep-apnea-pediatric-case-report
#9
Corneliu Toader, MioriŢa Toader, Alina Stoica, Gabriel Pop, Alina Oprea, Anca Simona Constantin, Liviu Niculescu, Iolanda Cristina Vivisenco, Mircea Stelian Drăghici, Andrei Osman, Carmen Aurelia Mogoantă
The commonest cause of head and neck malignancy in pediatric patients is lymphoma. A particular case is the tonsillar lymphoma. Even though unilateral tonsillar enlargement represents an ominous sign for neoplasia, clinical manifestations vary and are non-specific. Therefore, a delayed diagnosis is performed which compromises optimal therapy and hinders the prognosis. We present the case of a 5-year-old boy who was initially diagnosed with obstructive sleep apnea, without reported systemic complaints. Asymmetric tonsillar hypertrophy created the premises for performing a tonsillectomy to rule out malignancy...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27823719/individual-and-socio-demographic-factors-related-to-presenting-problem-and-diagnostic-impressions-at-a-pediatric-sleep-clinic
#10
Sonia L Rubens, Kristina E Patrick, Ariel A Williamson, Melisa Moore, Jodi A Mindell
OBJECTIVE: Individual and socio-demographic factors have been found to be associated with sleep disturbances in children. Few studies have examined these factors among children presenting for care at pediatric sleep clinics. This study examined individual and socio-demographic factors in association with presenting problems and diagnostic impressions for new patients at an interdisciplinary pediatric sleep clinic. METHODS: Data were collected from electronic medical records of 207 consecutive patients (54% male, 59% White, Meanage = 7...
September 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27810015/pediatric-obstructive-sleep-apnea
#11
REVIEW
Zarmina Ehsan, Stacey L Ishman
Screening for obstructive sleep apnea (OSA) with in-laboratory polysomnography is recommended for children with sleep disordered breathing. Adenotonsillectomy is the first-line therapy for pediatric OSA, although intranasal steroids and montelukast can be considered for those with mild OSA and continuous positive airway pressure for those with moderate to severe OSA awaiting surgery, poor surgical candidates or persistent OSA. Bony or soft tissue upper airway surgery is reasonable for children failing medical management or those with persistent OSA following adenotonsillectomy...
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27802246/morphometry-analysis-of-basal-ganglia-structures-in-children-with-obstructive-sleep%C3%A2-apnea
#12
Jian Lv, Lin Shi, Lei Zhao, Jian Weng, Vincent C T Mok, Winnie C W Chu, Defeng Wang
BACKGROUND: Obstructive sleep apnea (OSA) affects both adults and children, likely mediated by the deficits of various brain regions. The association between structural alterations in the brain and OSA syndrome have been reported in adult patients, but the corresponding evidence for OSA children is still limited. OBJECTIVE: The proposed study aimed to investigate the structural alterations in the brain of children with OSA, with focus on basal ganglia structures...
October 6, 2016: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/27796040/rapid-maxillary-expansion-for-pediatric-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis
#13
Macario Camacho, Edward T Chang, Sungjin A Song, Jose Abdullatif, Soroush Zaghi, Paola Pirelli, Victor Certal, Christian Guilleminault
OBJECTIVES/HYPOTHESIS: To perform a systematic review with meta-analysis for sleep study outcomes in children who have undergone rapid maxillary expansion (RME) as treatment for obstructive sleep apnea (OSA). DATA SOURCES: PubMed/MEDLINE and eight additional databases. REVIEW METHODS: Three authors independently and systematically reviewed the international literature through February 21, 2016. RESULTS: Seventeen studies reported outcomes for 314 children (7...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27793516/-overnight-polysomnography-versus-respiratory-polygraphy-in-the-diagnosis-of-pediatric-obstructive-sleep-apnea
#14
P Franco, H Bourdin, F Braun, J Briffod, I Pin, M-J Challamel
The French Society of Research and Sleep Medicine (SFRMS) organized a meeting on obstructive sleep apnea syndrome (OSAS) in children. A multidisciplinary group of specialists (pulmonologists, ENT surgeons, pediatricians, neurophysiologists, sleep specialists) drew up a consensus document on the value of electrophysiological recordings in the diagnosis of OSAS in children. Technical considerations and recommended sensors, respiratory event definitions, and scoring criteria are presented according to the 2012 and 2014 recommendations of the American Academy of Sleep Medicine (AASM)...
October 25, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27789174/-pediatric-obstructive-sleep-apnea-syndrome-treatment-strategy
#15
J Cohen-Lévy, J Potenza, V Couloigner
Pediatric obstructive sleep apnea syndrome (OSAS) has a multifactorial origin. For the child with no dysmorphic disorders or comorbidities, its main etiology is pharyngeal soft tissue hypertrophy, a dimensional reduction of the facial skeletal frame restricting the airway, an anomaly of muscular tone, or a combination of these factors. Consequently, proper diagnosis and treatment planning for these children can require several medical specialties, according to the complexity, severity, and persistence of OSAS: ear-nose-throat specialists (ENT), pneumologists/allergologists, dentofacial orthopedists/orthodontists, and physical therapists/speech therapists...
October 24, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27787950/validation-of-the-pediatric-sleep-questionnaire-in-children-with-asthma
#16
Zarmina Ehsan, Carolyn M Kercsmar, Jennifer Collins, Narong Simakajornboon
OBJECTIVE: The prevalence of obstructive sleep apnea (OSA) is higher in children with poorly controlled asthma. We aimed to determine the validity of the Pediatric Sleep Questionnaire (PSQ) to screen for OSA in children with asthma. METHODS: This retrospective review encompassed sleep studies and medical records of asthmatic children evaluated in the sleep center at CCHMC over 13 years. Measures of validity were calculated using various cut-off values for obstructive apnea-hypopnea index (OI; >1, >2, >5) and PSQ scores (>0...
October 27, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27775805/craniofacial-morphology-and-airflow-in-children-with-primary-snoring
#17
V Luzzi, G Di Carlo, M Saccucci, G Ierardo, E Guglielmo, M Fabbrizi, A M Zicari, M Duse, F Occasi, G Conti, E Leonardi, A Polimeni
OBJECTIVE: Sleep-disordered breathing (SDB) is among the most common diseases and includes a group of pathological conditions that form a severity continuum from primary snoring (PS) to obstructive sleep apnea (OSA). SDB presents a multifactorial etiology and in children, it is often linked to adenotonsillar hypertrophy, which may lead to an alteration of the breathing pattern. Therefore, several studies hinted at the existence of a correlation between SDB and the alteration of craniofacial growth...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27768852/associations-among-neighborhood-race-and-sleep-apnea-severity-in-children-a-six-city-analysis
#18
Rui Wang, Yan Dong, Jia Weng, Emily Z Kontos, Ronald D Chervin, Carol L Rosen, Carole L Marcus, Susan Redline
RATIONALE: Prior research found that individual-level environmental and social indicators did not explain the racial disparity in obstructive sleep apnea syndrome. Neighborhood socioeconomic variables, risk factors for a range of adverse behavioral and health outcomes, may better explain this racial disparity and help identify modifiable intervention targets. OBJECTIVES: To evaluate the associations of neighborhood socioeconomic variables with obstructive sleep apnea severity and to assess whether the neighborhood variables explain the association between race and obstructive sleep apnea severity...
October 21, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27741107/inflammatory-cytokines-in-pediatric-obstructive-sleep-apnea
#19
Yu-Shu Huang, Christian Guilleminault, Fang-Ming Hwang, Chuan Cheng, Cheng-Hui Lin, Hsueh-Yu Li, Li-Ang Lee
Pediatric obstructive sleep apnea (OSA) is associated with chronic systemic inflammation and with cognitive impairments. This study aimed to investigate the status of proinflammatory cytokines, particularly interleukin 17 (IL-17) and interleukin 23 (IL-23) and cognition in pediatric OSA.Controls and OSA children participated in the study. Exclusion criteria were adenotonsillectomy, heart, neurological and severe psychiatric diseases, craniofacial syndromes, and obesity. Polysomnogram was followed by serum testing for inflammatory markers and neurocognitive tests such as continuous performance task (CPT) and Wisconsin card sorting test, questionnaires, analyses of plasma high-sensitivity C-reactive protein (HS-CRP), tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), IL-17, and IL-23...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27729152/orofacial-motor-functions-in-pediatric-obstructive-sleep-apnea-and-implications-for-myofunctional-therapy
#20
Cláudia Maria de Felício, Franciele Voltarelli da Silva Dias, Gislaine Aparecida Folha, Leila Azevedo de Almeida, Jaqueline Freitas de Souza, Wilma Terezinha Anselmo-Lima, Luciana Vitaliano Voi Trawitzki, Fabiana Cardoso Pereira Valera
OBJECTIVES: The purposes of this study were (1) to identify possible differences in muscular and orofacial functions between children with obstructive sleep apnea (OSA) and with primary snoring (PS); (2) to examine the standardized difference between normal values of myofunctional scores and those of subjects with OSA or PS; and (3) to identify the features associated with OSA. METHODS: Participants were 39 children (mean age 8 ± 1.2 years) of which, 27 had a diagnosis of OSA and 12 had PS...
November 2016: International Journal of Pediatric Otorhinolaryngology
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