554 Utilization of Pediatric Sleep Questionnaire to Screen for Obstructive Sleep Apnea in a Difficult-to-treat Asthma Cohort

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A219-A219
Author(s):  
Nancy Lin ◽  
Sumalee Hantragool ◽  
Guixia Huang ◽  
Md Monir Hossain ◽  
Karen McDowell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Asthma Control ◽  
Clinical Characteristics ◽  
Negative Group ◽  
Positive Group ◽  
Obstructive Sleep ◽  
The Mean ◽  
Pediatric Sleep Questionnaire

Abstract Introduction Early detection and management of obstructive sleep apnea(OSA) could improve asthma control in children with difficult-to-treat(DTT) asthma. The purpose of this study was to assess the effectiveness of the pediatric sleep questionnaire(PSQ) to screen for OSA in children with DTT asthma, and to compare clinical characteristics between those with positive and negative PSQ scores. Methods A prospective study of 81 children with DTT asthma was completed from 2015–2017. The PSQ, Epworth sleepiness scale(ESS), Pediatric Quality of Life(PQL), and the academic performance questionnaires(APQ) were administered during clinic visits. Polysomnography(PSG) was recommended for PSQ score>0.33. Medical records were reviewed for asthma clinical characteristics. The cohort was separated into positive(PSQ>0.33) and negative PSQ score(PSQ≤0.33) groups for analysis. Results The mean age of the cohort was 11.3±4.5 years and the mean body mass index was 22±7.6 kg/m2. Sixty-two percent were male and 68% were African-American. Forty-nine(53%) subjects had positive PSQ (0.5[0.4 – 0.7]). The positive group had higher ESS score (10.5[8 – 13] vs. 6[2 – 8], p<0.0001) and lower total PQL score (58.7[47.8–72.8] vs. 79.4[70.7 – 87], p<0.0001) than the negative group. There was no difference between APQ scores(p=0.07). The positive group had lower asthma control test(ACT) scores than the negative group (17.5[15 – 20.5] vs. 21[19 – 22], p<0.0001). Furthermore, the positive group was more likely to have gastroesophageal reflux (OR: 3.97, 95%CI: 1.7 to 9.1, p=0.0018). Twenty-nine(59%) subjects in the positive group had subsequent PSG, and 17(58.6%) subjects were diagnosed with OSA (14 mild OSA, 1 moderate OSA, 2 severe OSA). The mean obstructive index in the positive group was 3±5.5 events/hour. There was 1 subject with central apnea and alveolar hypoventilation. Of the 17 subjects with OSA, all received treatment with nasal steroids, 3 were treated with non-invasive positive pressure ventilation, and 4 had surgical intervention. Conclusion Children with DTT asthma who have positive PSQ have higher degree of daytime sleepiness, lower quality of life and worse asthma control. The positive group was more likely to have GERD, which may suggest a relationship between nighttime asthma symptoms and OSA. Further studies are needed to evaluate the effects of OSA treatment on asthma control. Support (if any):

Persistent Obstructive Sleep Apnea Burden on Family Finances and Quality of Life

2021 ◽  
pp. 019459982098656
Author(s):  
Mathieu Bergeron ◽  
Stacey L. Ishman
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Financial Impact ◽  
Family Impact ◽  
Financial Toxicity ◽  
Obstructive Sleep ◽  
The Family ◽  
The Mean ◽  
Comprehensive Score

Objective We previously found that financial concerns negatively affect the quality of life of families of children with persistent obstructive sleep apnea (OSA) after tonsillectomy. The goal is to quantify the financial impact on families of children with persistent OSA and assess contributing factors. Study Design Cross-sectional survey study with comparison group. Setting Upper airway center at a tertiary pediatric hospital. Methods Participants included consecutive children with persistent OSA from September to October 2017. Healthy children seen in a general otolaryngology clinic served as controls. Families of both groups completed the Family Impact Questionnaire and the modified Comprehensive Score for Financial Toxicity (COST). Results Families of the 50 patients (25 study and 25 control) completed the surveys: the mean age was 6.4 years (95% CI, 5.0-7.8), and 19 (38%) were female. There were no differences in age, sex, race, or insurance status between groups ( P > .05). The mean apnea-hypopnea index for the study group was 7.9 events/h (range, 5.5-10.3), and 40% (10/25) had Down syndrome. Positive airway pressure and/or oxygen were used by 72% (18/25). The Comprehensive Score for Financial Toxicity for study patients (21.9; 95% CI, 14.8-26.0) was significantly lower than for controls (30.2; 95% CI, 26.6-30.8; P = .003), reflecting elevated financial toxicity. Study families reported greater financial impact on the Family Impact Questionnaire (8.4; 95% CI, 6.1-10.7) versus controls (3.6; 95% CI, 1.8-5.4; P = .002); concerns regarding missed days of work and school were common (30.7%). Conclusion Families of children with persistent OSA reported a high financial burden related to their children’s disease and were more likely to report financial toxicity than families of controls. Concern regarding missed work and school associated with appointments and treatment was a significant factor.

The Frequency of Obstructive Sleep Apnea in Asthmatic Patients, and Impact of OSA on Asthma Control

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Laila M Abdel Ghaffar Hegazy ◽  
Ahmad Mostafa Allam ◽  
Marwa Salah Helmy
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Asthma Control ◽  
Bronchial Asthma ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
Asthmatic Patients ◽  
Obstructive Sleep

Abstract Background Obstructive sleep apnea (OSA) and asthma are common inflammatory respiratory diseases of childhood. The similarities between and the parallel rise of both diseases raise the question of whether OSA is indeed more common in asthmatic children. Objectives The present study is cross section study conducted on fifty children with bronchial asthma the aim of study was to evaluate the frequency of obstructive sleep apnea in asthmatic patients, and impact of OSA on asthma control. Patients and Methods The present work is a Cross-sectional study conducted on fifty Children (27 females and 23 males) aging 5 to 18 years diagnosed as bronchial asthma following up in pulmonology clinic or admitted to pulmonology department in Pediatric Hospital- Ain Shams University. Patients were excluded from presence of any other chronic chest diseases, any congenital malformation in upper respiratory, any genetic disease or inborn error of metabolism, morbid obesity and other medical co morbidities that might interfere with sleep quality. All patients were subjected to full history taking, meticulous general and local chest examination, pulmonary function tests and exposed questionnaire: Asthma control questionnaire (ACQ) and OSA-18 quality of life questionnaire. Children were positive OSA with OSA-18 quality of life questionnaire referred to sleep study. Results 54 % of cases were females and 46% were males. There mean age=10.1, mean of OSA score =75.6. 20% diagnosed OSA according to questionnaire. OSA score increased in patients with history of PICU and hospital admission. OSA score was highly correlated with severity and degree of control of bronchial asthma. 10% of children were positive OSA with OSA-18 quality of life questionnaire suggestive have obstructive sleep apnea according to polysomnogram. Conclusion OSA has a direct and significant impact on asthma severity and control. Asthma and OSA are common disorders, and the concomitant presence of both conditions can be detrimental. Due to the bidirectional association of both conditions, we as clinicians should be aware of it.

Upper Airway Stimulation in Patients Who Have Undergone Unsuccessful Prior Palate Surgery: An Initial Evaluation

2018 ◽  
Vol 159 (5) ◽  
pp. 938-940 ◽  
Author(s):  
Colin Huntley ◽  
Adam Vasconcellos ◽  
Karl Doghramji ◽  
Benedikt Hofauer ◽  
Clemens Heiser ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Upper Airway Stimulation ◽  
Obstructive Sleep ◽  
Prior Surgery ◽  
The Mean

Upper airway stimulation therapy (UAS) is a new option for treatment of obstructive sleep apnea (OSA) in patients unable to tolerate continuous positive airway pressure (CPAP). We set out to evaluate the effectiveness of UAS in patients who have undergone prior palate surgery. We designed a retrospective review and evaluated patients undergoing UAS at 2 academic centers. We recorded demographic and pre- and postoperative polysomnogram (PSG) data. We compared the cohort of patients who had undergone prior palate surgery, “prior surgery,” to the cohort who had not, “no prior surgery.” A total of 164 patients were included in the study: 23 in the prior surgery and 141 in the no prior surgery groups. The mean age was significantly higher in the no prior surgery group ( P = .020). There were no other significant differences when comparing demographic, quality of life, or PSG variables between cohorts. UAS therapy is an option to treat OSA in patients having undergone unsuccessful prior palate surgery.

scholarly journals Long-term Impact of Adenotonsillectomy on the Quality of Life of Children with Sleep-disordered breathing

2020 ◽  
Author(s):  
Juliana Alves Sousa Caixeta ◽  
Jessica Caixeta Silva Sampaio ◽  
Vanessa Vaz Costa ◽  
Isadora Milhomem Bruno da Silveira ◽  
Carolina Ribeiro Fernandes de Oliveira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Long Term Effects ◽  
Obstructive Sleep ◽  
Long Term Impact ◽  
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.

scholarly journals Comparisons of Thyroid Hormone, Intelligence, Attention, and Quality of Life in Children with Obstructive Sleep Apnea Hypopnea Syndrome before and after Endoscopic Adenoidectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hui-Wei Feng ◽  
Tao Jiang ◽  
Hong-Ping Zhang ◽  
Zhe Wang ◽  
Hai-Ling Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Thyroid Hormone ◽  
Intelligence Quotient ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Before And After ◽  
Hypopnea Syndrome

Objective. The aim of this study was to compare the differences in thyroid hormone, intelligence, attention, and quality of life (QoL) of children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after endoscopic adenoidectomy.Method. A total of 35 OSAHS children (21 males and 14 females with a mean age of6.81±1.08years) were included in this study for analyzing the levels of thyroid hormone, intelligence, attention, and QoL. There were 22 children underwent endoscopic adenoidectomy with bilateral tonsillectomy (BT), while the other 13 children who underwent endoscopic adenoidectomy without bilateral tonsillectomy without BT.Results. Our results revealed no significant difference in serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) levels in OSAHS children before and after endoscopic adenoidectomy (allP>0.05). However, there were significant differences in full-scale intelligence quotient (FIQ) (92.45±5.88versus106.23±7.39,P<0.001), verbal intelligence quotient (VIQ) (94.17±15.01versus103.91±9.74,P=0.006), and performance intelligence quotient (PIQ) (94.12±11.04versus104.31±10.05,P=0.001), attention (98.48±8.74versus106.87±8.58,P<0.001), and total OSA-18 scores (87.62±17.15versus46.61±10.15,P<0.001) between before and after endoscopic adenoidectomy in OSAHS children.Conclusion. Our findings provided evidence that the intelligence, attention, and QoL of OSAHS children may be significantly improved after endoscopic adenoidectomy.

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