scholarly journals Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Avivit Brener ◽  
Yael Lebenthal ◽  
Sigal Levy ◽  
Galit Levi Dunietz ◽  
Orna Sever ◽  
...  
Keyword(s):  
Head Circumference ◽  
Sleep Disordered Breathing ◽  
Critical Role ◽  
Hdl Cholesterol ◽  
Laboratory Evaluation ◽  
Sleep Study ◽  
Childhood Growth ◽  
Protein Levels ◽  
Offspring Growth ◽  
Disordered Breathing

Abstract Sleep-disordered breathing (SDB) during pregnancy has been linked to adverse fetal outcomes. Since the intrauterine milieu plays a critical role in childhood growth, we explored the interactions between maternal SDB and offspring growth and adiposity patterns during infancy. Fifty-eight healthy women with uncomplicated pregnancies underwent an objective sleep study and laboratory evaluation during the third trimester, their offspring underwent a 3-year growth surveillance. The 14 (24.1%) women with SDB had a higher body mass index (BMI) (P = 0.003), elevated C-reactive protein levels (P = 0.003), and decreased HDL-cholesterol levels (P = 0.009) than the women without SDB. A general linear model evaluated the interactions between maternal SDB and offspring growth and adiposity measurements after controlling for gestational age and maternal and paternal BMIs. The offspring of mothers with SDB had a significantly smaller head circumference at birth (P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). Their growth pattern was distinguished by compromised birth weight-to-length, rapid catch-up growth, and an increase in both weight-to-length and triceps thickness by the age of three (P < 0.001 and P = 0.001, respectively). Our findings suggest that maternal SDB during pregnancy affects head circumference growth and adiposity acquisition from birth through infancy.

scholarly journals OR10-01 Mild Maternal Sleep Disordered Breathing in Pregnant Women Affects Growth Patterns of Head Circumference and Adiposity During the First Three Years of Life

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Avivit Brener ◽  
Yael Lebenthal ◽  
Sigal Levy ◽  
Galit Levi Dunietz ◽  
Orna Sever ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Head Circumference ◽  
Sleep Disordered Breathing ◽  
Growth Patterns ◽  
Distinctive Pattern ◽  
Third Trimester ◽  
Sleep Study ◽  
The Third ◽  
Study Results ◽  
Disordered Breathing

Abstract Background The intrauterine environment affects growth and adiposity acquisition from the fetal period until adulthood. Mild sleep disordered breathing (SDB) during pregnancy is a common underdiagnosed medical condition in healthy women. We aimed to investigate the interaction between maternal isolated SDB during the third trimester of pregnancy and the offspring’s growth and adiposity during the first three years of life. Methods Healthy pregnant women in the third trimester of an uncomplicated singleton pregnancy who were followed at the low-risk obstetric surveillance clinic of our hospital were recruited between 4/2013 and 5/2016. They were followed from enrollment until their offspring was three years old. During their third trimester of pregnancy, they underwent an ambulatory overnight sleep study by means of a validated sleep technology [SDB defined as apnea hypopnea index (AHI) ≥5]. Fasting blood samples were drawn on the following morning for glucose, insulin, HbA1c, lipid profile and C-reactive protein (CRP) levels. The offspring’s growth (length, weight and head circumference) and adiposity (subscapular and triceps skinfolds) parameters were measured at birth, 1 and 4 months, and 1, 2, and 3 years of age. Growth parameters were presented as standard deviation scores using the CDC growth charts. A general linear model was used to evaluate the interaction between maternal SDB and her offspring’s growth and adiposity measurements, after controlling for gestational week at delivery and maternal and paternal body mass index (BMI). Results Fourteen of 58 women (24.1%) were diagnosed with SDB (AHI range 5.3–14.7). They had a significantly higher mean BMI during the third trimester of pregnancy (30.1 ± 3.9 vs 27.2 ± 3.5, P = 0.011), elevated CRP levels, and decreased HDL-cholesterol levels (6.39 ± 2.29 mg/L vs 4.28 ± 2.15 mg/L, P = 0.003 and 67 ± 14 mg/dl vs 82 ± 19 mg/dl, P = 0.009, respectively) compared to women with normal sleep study results. Offspring of mothers with SDB had a smaller mean head circumference SDS at birth (-0.95 ± 0.70 vs -0.30 ± 0.71, P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). They also had increased mean adiposity at birth measured by triceps and subscapular skinfolds (6.8 ± 1.8 mm vs 5.4 ± 1.2 mm, P =0.002 and 5.8 ± 1.3 mm vs 5.0 ± 1.0 mm, P =0.019, respectively), with a distinctive pattern of increased triceps thickness at age 3 years (P = 0.001). There was no significant difference in offspring length or weight between groups. Conclusions Our findings suggest that isolated maternal SDB during pregnancy affected longitudinal head circumference growth and adiposity acquisition in the fetus and during the first three years of life.

569 Correlation between age and initial findings of sleep disordered breathing in children with achondroplasia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A224-A225
Author(s):  
Fayruz Araji ◽  
Cephas Mujuruki ◽  
Brian Ku ◽  
Elisa Basora-Rovira ◽  
Anna Wani
Keyword(s):  
Sleep Apnea ◽  
Primary Care Physicians ◽  
Sleep Disordered Breathing ◽  
Upper Airway ◽  
Sleep Study ◽  
Surgical Interventions ◽  
Screening Guidelines ◽  
Obstructive Sleep ◽  
Children’S Sleep ◽  
Disordered Breathing

Abstract Introduction Achondroplasia (ACH) occurs approximately 1 in 20,000–30,000 live births. They are prone to sleep disordered breathing specifically due to the upper airway stenosis, enlarged head circumference, combined with hypotonia and limited chest wall size associated with scoliosis at times. The co-occurrence of sleep apnea is well established and can aide in the decision for surgical intervention, however it is unclear at what age children should be evaluated for sleep apnea. Screening is often delayed as during the daytime there is no obvious gas exchange abnormalities. Due to the rareness of this disease, large studies are not available, limiting the data for discussion and analysis to develop guidelines on ideal screening age for sleep disordered breathing in children with ACH. Methods The primary aim of this study is to ascertain the presence of sleep disorder breathing and demographics of children with ACH at time of first polysomnogram (PSG) completed at one of the largest pediatric sleep lab in the country. The secondary aim of the study is to identify whether subsequent polysomnograms were completed if surgical interventions occurred and how the studies differed over time with and without intervention. Retrospective review of the PSGs from patients with ACH, completed from 2017–2019 at the Children’s Sleep Disorders Center in Dallas, TX. Clinical data, demographics, PSG findings and occurrence of interventions were collected. Results Twenty-seven patients with the diagnosis of ACH met criteria. The average age at the time of their first diagnostic PSG was at 31.6 months of age (2.7 years), of those patients 85% had obstructive sleep apnea (OSA),51% had hypoxemia and 18% had hypercapnia by their first diagnostic sleep study. Of those with OSA, 50% were severe. Majority were females, 55%. Most of our patients were Hispanic (14%), Caucasian (9%), Asian (2%), Other (2%), Black (0%). Each patient had an average of 1.9 PSGs completed. Conclusion Our findings can help create a foundation for discussion of screening guidelines. These guidelines will serve to guide primary care physicians to direct these patients to an early diagnosis and treatment of sleep disordered breathing. Support (if any):

Abstract 11556: Association of Sleep Disordered Breathing and ECG R-Wave to Radial Artery Pulse Delay: The MESA Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Younghoon Kwon ◽  
David R Jacobs ◽  
Pamela L Lutsey ◽  
Peter Hannan ◽  
Julio A Chirinos ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Radial Artery ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Ventricular Ejection Fraction ◽  
Pulse Delay ◽  
Disordered Breathing

Background: Arterial stiffness is a well-recognized predictor of cardiovascular disease (CVD). ECG R-wave to Radial artery pulse delay (RRD) is a novel hemodynamic index in which arterial stiffness is an important component (shorter delay = Higher arterial stiffness) and is obtainable from a single tonometric measurement at the radial artery with simultaneous ECG. Sleep disordered breathing (SDB) has emerged as a risk factor for CVD. The aim of the study was to determine the association of SDB with RRD. Methods: Multi-Ethnic Study of Atherosclerosis participants in 2010-2012 without overt CVD who underwent a sleep study, radial artery tonometry and cardiac MRI were eligible for this cross-sectional analysis (N = 1173, Mean [SD] age: 67.8 ± 8.8, Women: 55.4%). Independent associations between SDB indices including apnea hypopnea index (AHI) and oxygen (O2) desaturation index (ODI: events with more than 4% O2 desaturation), and RRD (transit time in msec) were examined. Model was constructed to adjust for isovolumetric contraction time, another component of RRD, by including measures of contractility and preload (left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) respectively). Results: Median [IQR] of AHI and ODI were 7.9/hr [2.9- 18.0] and 7.5/hr [3.0- 17.5] respectively. Adjusting for transit path length, demographic factors, BMI and CVD risk factors, both AHI and ODI were inversely associated with RRD (β= -50.3 msec per SD, p = 0.09 and β= -0.60.2 msec per SD, p = 0.04 respectively). In gender stratified analyses given presence of significant interaction, measures of SDB were predictive of RRD only in men. No significant associations were found with key nocturnal hypoxemia indices including mean O2 saturation (SpO2), percent time with SpO2less than 90 % and minimum SpO2. Men, older age, Asian race, high blood pressure, LVEF and LVEDV were also inversely associated with RRD. Conclusion: SDB was associated with shorter RRD implying higher arterial stiffness in men only. These findings suggest the importance of apnea related dynamic change in SpO2 (intermittent hypoxia and reoxygenation) in its potential link to arterial stiffness and also highlights effect modification by gender in the association between the two.

scholarly journals Author Correction: Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Avivit Brener ◽  
Yael Lebenthal ◽  
Sigal Levy ◽  
Galit Levi Dunietz ◽  
Orna Sever ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Maternal Sleep ◽  
Offspring Growth ◽  
Disordered Breathing

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

scholarly journals Prevalence and Correlates of Sleep-Disordered Breathing in Older Men: Osteoporotic Fractures in Men Sleep Study

2007 ◽  
Vol 55 (9) ◽  
pp. 1356-1364 ◽  
Author(s):  
Reena Mehra ◽  
Katie L. Stone ◽  
Terri Blackwell ◽  
Sonia Ancoli Israel ◽  
Thuy-Tien L. Dam ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Osteoporotic Fractures ◽  
Older Men ◽  
Sleep Study ◽  
Disordered Breathing

Abstract TP208: Medullary Infarction is Associated with Severe Sleep Disordered Breathing

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Shuichi Fujii ◽  
Kensaku Shibazaki ◽  
Kenichiro Sakai ◽  
Junya Aoki ◽  
Junichi Uemura ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Multivariate Regression ◽  
Sleep Disordered Breathing ◽  
Multivariate Regression Analysis ◽  
Stroke Patients ◽  
Sleep Study ◽  
Respiratory Disturbance ◽  
The Relationship ◽  
Medullary Infarction ◽  
Disordered Breathing

Background and Purpose: A relationship between presence or severity of sleep disordered breathing (SDB) and site of lesion in ischemic stroke patients has been unclear. Our aim of the present study was to investigate the relationship between presence or severity of SDB and site of ischemic lesions in stroke patients. Subjects and Methods: Between April 2010 and March 2012, consecutive ischemic stroke patients within 24 hours of onset were prospectively enrolled. Ischemic lesions were identified by MRI on admission. Patient underwent sleep study to evaluate the presence and severity of SDB within 7 days after admission. SDB was defined as a respiratory disturbance index (RDI; apnea/hypopnea events per hour) ≥ 5, and severe SDB was defined as a RDI ≥ 40. We investigated the relationship between presence or severity of SDB and clinical characteristics including site of ischemic lesions. Results: A total of 214 patients (mean age 71.3, male 132) were enrolled. Supratentrial lesion was observed in 166 (77.6%) patients and right side lesion in 101 (47.2%) patients. Sites of ischemic lesions were as follows; cortex (n=11), subcortex (n=35), cortex plus subcortex (n=75), basal ganglia (n=57), thalamus (n=13), midbrain (n=3), pons (n=27), medulla (n=11), and cerebellum (n=22). Sleep study was performed at 4 days (median). The median RDI (IQR) was 20 (10-34). SDB patients were found in 187 (87%) patients. There were no significant differences in frequency of each site of lesions between SDB and non-SDB patients. Severe SDB was observed in 42 (19.6%) patients. Age (75 (70-83) vs. 72 (64-78), p=0.047), NIHSS score on admission (3 (1-10) vs. 7 (2-12), p=0.047), the frequency of atrial fibrillation (41% vs. 22%, p=0.012) and medullary lesions (12% vs. 4%, p=0.027) were significantly higher in severe SDB patients than non-severe SDB. Multivariate regression analysis demonstrated that medullary lesions (OR 5.5, 95%CI 1.41-21.8, p=0.014) was independently associated with severe SDB. Conclusions: Medullary lesion in stroke patients should be associated with severe SDB.

Abstract 2457: Atrial Fibrillation is Associated with Severe Sleep Disordered Breathing TIA and Stroke Patients

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Kensaku Shibazaki ◽  
Kazumi Kimura ◽  
Junichi Uemura ◽  
Kenichiro Sakai ◽  
Shuichi Fuii
Keyword(s):  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Multivariate Regression ◽  
Sleep Disordered Breathing ◽  
Japanese Patients ◽  
Multivariate Regression Analysis ◽  
Stroke Patients ◽  
Sleep Study ◽  
Factors Associated ◽  
Disordered Breathing

Background and Purpose Sleep disordered breathing (SBD) was reported to be a risk factor for cerebrovascular disease. We investigated the frequency of SDB in Japanese patients with acute transient ischemic attack (TIA) and stroke and the factors associated with severe SDB in Japan. Methods Between May 2010 and April 2011, we prospectively enrolled TIA and stroke patients within 24 hours of onset and performed sleep study up to 7 days after admission. SBD was defined as respiratory disturbance index (RDI: apnea or hypopnea event per hour) ≥5. Patients were divided into 2 groups according to the RDI value as follows: ≥30(severe) and <30(none or non-severe). We demonstrated the frequency of SDB and the factors associated with severe SDB were investigated by multivariate regression analysis. Results A total of 150 patients (92 males; mean age, 72.8 years) were enrolled in this study; 28 had TIA and 122 had stroke. The mean time from admission to sleep study was 4 days. Mean RDI was 22.2±17.6. SDB was observed in 126(84%) patients. Frequencies of SDB were as follows: 21(75%) patients in TIA, 105(86%) in stroke [8/10(80%) in large artery atherosclerosis, 14/14(100%) in small vessel occlusion, 37/41(90%) in cardioembolism, 46/57(81%) in other cause of stroke/undetermined]. Severe SDB was observed in 44 (29%) patients; 21% in TIA and 31% in stroke. Frequencies of male (75% for the severe SDB group vs. 56% for the non-severe SDB group, p=0.027), atrial fibrillation (39% vs. 23%, p=0.045), body mass index (23.8±3.8 vs. 22.3±3.8, p=0.043), and neck circumference (37.8±4.3 vs. 35.8±4.2, p=0.012) were significantly higher in the severe SDB than in the non-severe SDB. Metabolic syndrome (36% vs. 21%, p=0.057) and waist circumference (88.9±9.8 vs. 85.5±9.3, p=0.080) showed a tendency toward higher in the severe SDB group than in the non-severe SDB group. There were no significant differences in age, prior stroke, vascular risk factors, Glasgow Coma Scale, and NIHSS score on admission. On multivariate regression analysis, atrial fibrillation (odds ratio, 2.5; 95% confidence interval, 1.079-5.836, p=0.0326) was found to be independently associated with severe SDB. Conclusions Most Japanese patients with acute TIA and stroke had SDB, and the presence of atrial fibrillation was associated with severe SDB.

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