The influence of body mass on long-term cognitive performance of children treated for sleep-disordered breathing

Abstract Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.

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Combined Open Rhinoplasty With Spreader Grafts and Laser-Assisted Uvuloplasty for Sleep-Disordered Breathing: Long-Term Subjective Outcomes

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2006.04.020 ◽

2006 ◽

Vol 64 (8) ◽

pp. 1241-1247 ◽

Cited By ~ 14

Author(s):

Joseph E. Cillo ◽

Richard Finn ◽

Richard M. Dasheiff

Keyword(s):

Sleep Disordered Breathing ◽

Open Rhinoplasty ◽

Subjective Outcomes ◽

Disordered Breathing

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Influence of Untreated Sleep-Disordered Breathing on the Long-Term Prognosis of Patients With Cardiovascular Disease

The American Journal of Cardiology ◽

10.1016/j.amjcard.2008.10.035 ◽

2009 ◽

Vol 103 (5) ◽

pp. 730-734 ◽

Cited By ~ 38

Author(s):

Noriaki Takama ◽

Masahiko Kurabayashi

Keyword(s):

Cardiovascular Disease ◽

Sleep Disordered Breathing ◽

Long Term Prognosis ◽

Disordered Breathing

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IOT enabled T-shirt for long-term monitoring of sleep disordered breathing

10.1109/rteict52294.2021.9573917 ◽

2021 ◽

Author(s):

Sunil K N Kumar ◽

Arjun G B Kumar ◽

Rajendra P Prasad ◽

Akash R Bhatagunaki ◽

S U Jeevan ◽

...

Keyword(s):

Sleep Disordered Breathing ◽

Long Term Monitoring ◽

Term Monitoring ◽

Disordered Breathing

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MinimallyInvasive Radiofrequency Surgery in Sleep-Disordered Breathing

Healthcare ◽

10.3390/healthcare7030097 ◽

2019 ◽

Vol 7 (3) ◽

pp. 97

Author(s):

Ankit Patel ◽

Bhik Kotecha

Keyword(s):

Sleep Disordered Breathing ◽

Sleep Apnoea ◽

Long Term Outcomes ◽

Sustained Improvement ◽

Radiofrequency Surgery ◽

Obstructive Sleep ◽

Good Quality Research ◽

Disordered Breathing

Sleep-disordered breathing encompasses a spectrum of conditions ranging from simple snoring to obstructive sleep apnoea (OSA). Radiofrequency surgery represents a relatively new technique available to surgeons involved in managing this condition. Its principal advantage relates to its minimally invasive nature resulting in a reduced morbidity when compared to traditional sleep surgery. The presence of good-quality research evaluating the long-term outcomes is currently scarce, although the short-term data is promising. Careful patient selection appears to be paramount in obtaining a sustained improvement. The role of radiofrequency surgery in sleep-disordered breathing has been reviewed.

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Clinical Staging for Sleep-Disordered Breathing

Otolaryngology ◽

10.1067/mhn.2002.126477 ◽

2002 ◽

Vol 127 (1) ◽

pp. 13-21 ◽

Cited By ~ 315

Author(s):

Michael Friedman ◽

Hani Ibrahim ◽

Lee Bass

Keyword(s):

Body Mass Index ◽

Success Rate ◽

Body Mass ◽

Sleep Disordered Breathing ◽

Staging System ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Clinical Staging ◽

Disordered Breathing

OBJECTIVE: The purpose of this study was to identify prognostic indicators that would lead to stratification of patients likely to have successful surgery for sleep-disordered breathing (SDB) versus those destined to fail. STUDY DESIGN: We retrospectively reviewed 134 patients to correlate palate position and tonsil size to the success of the UPPP as based on postoperative polysomnography results. Similar to our previously published data on the Friedman Score as a predictor of the presence and severity of SDB, the palate position was determined on physical examination of the oral cavity and was graded for each patient. This grade combined with tonsil size was used to stage the patients. Stage I was defined as having palate position 1 or 2 combined with tonsil size 3 or 4. Stage II was defined as having palate position 3 or 4 and tonsil size 3 or 4. Stage III patients had palate position 3 or 4 and tonsil size 0, 1, or 2. Any patient with body mass index of greater than 40 was placed in the stage III group. The results of uvulopalatopharyngoplasty (UPPP) were then graded as success or failure and success rates were compared by stage. SETTING: Academically affiliated tertiary care referral center. RESULTS: Stage I patients who underwent UPPP had a success rate of 80.6%, stage II patients had a success rate of 37.9%, and stage III patients had a success rate of 8.1%. CONCLUSION: A clinical staging system for SDB based on palate position, tonsil size, and body mass index is presented. It appears to be a valuable predictor of the success of UPPP. Additional studies and wider use of the staging system will ultimately define its role in the treatment of SDB.

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Long-Term Impact of Sleep-Disordered Breathing on Quality of Life in Children With Obesity

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.6998 ◽

2018 ◽

Vol 14 (03) ◽

pp. 451-458 ◽

Cited By ~ 3

Author(s):

Sherri L. Katz ◽

Joanna E. MacLean ◽

Nicholas Barrowman ◽

Lynda Hoey ◽

Linda Horwood ◽

...

Keyword(s):

Quality Of Life ◽

Sleep Disordered Breathing ◽

Long Term Impact ◽

Disordered Breathing

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0890 Sleep Disordered Breathing is Associated With Endothelial Dysfunction and Atherosclerosis in Young Adults: Preliminary Longitudinal Findings in the Penn State Child Cohort

SLEEP ◽

10.1093/sleep/zsaa056.886 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A339-A339

Author(s):

J Fernandez-Mendoza ◽

Z Gao ◽

K Brandt ◽

L Houser ◽

S L Calhoun ◽

...

Keyword(s):

Young Adults ◽

Endothelial Dysfunction ◽

Young Adulthood ◽

Sleep Disordered Breathing ◽

Population Based ◽

Apnea Hypopnea Index ◽

Penn State ◽

State Child ◽

Disordered Breathing

Abstract Introduction Sleep disordered breathing (SDB) in middle-age is an established risk factor for cardiovascular disease. However, population-based studies supporting its cardiovascular contribution at earlier stages of development are lacking, particularly with long-term follow-ups. Methods The Penn State Child Cohort is a population-based longitudinal sample of 700 children (8.7±1.7y), of whom 421 were followed-up 8.3 years later during adolescence (17.0±2.3y) with in-lab polysomnography (PSG). To date, 425 have been followed-up another 7.4 years later during young adulthood (24.4±2.6y) via a standardized survey and 136 of them (55.1% female, 21.3% racial/ethnic minority) have undergone a repeat of their PSG to ascertain apnea/hypopnea index. Subjects (n=121) also underwent Doppler ultrasounds to assess flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT). Linear regression models stratified by body mass index in young adulthood. Results SDB was cross-sectionally associated with lower FMD (β=-0.239, p=0.008) and greater CIMT (β=0.330, p<0.001) in young adulthood. Longitudinally, childhood (n=121) and adolescence (n=90) SDB were significantly associated with CIMT (β=0.327, p<0.001 and β=0.286, p=0.006, respectively), but not with FMD (β=-0.158, p=0.08 and β=-0.101, p=0.35, respectively). These associations, particularly longitudinal ones between childhood and adolescence SDB with CIMT in young adulthood, were stronger in overweight than normal weight subjects (e.g., β=0.310, p=0.030 and β =0.089, p=0.582, respectively). Conclusion SDB and obesity appear to be synergistically associated with endothelial dysfunction and atherosclerosis in young adults from the general population. These data suggest that a childhood exposure to chronic SDB is associated with long-term atherosclerosis, while endothelial dysfunction may be a short-term outcome. This ongoing 16-year longitudinal study will test whether the natural history of SDB from childhood through adolescence into young adulthood shows differential trajectories for cardiovascular morbidity. Support National Institutes of Health (R01HL136587, R01HL97165, R01HL63772, UL1TR000127)

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