Reliability and Validity of the Obstructive Sleep Apnea-18 Survey in Healthy Children and Children With Syndromic Craniosynostosis

Children with Down syndrome (DS) are at high risk for developing obstructive sleep apnea (OSA) compared to children without DS. The negative impact of OSA on health, behavior, and cognitive development in children with DS highlights the importance of timely and effective treatment. Due to the higher prevalence of craniofacial and airway abnormalities, obesity, and hypotonia in patients with DS, residual OSA can still occur after exhausting first-line options. While treatment commonly includes adenotonsillectomy (AT) and continuous positive airway pressure (CPAP) therapy, additional therapy such as medical management and/or adjuvant surgical procedures need to be considered in refractory OSA. Given the significant comorbidities secondary to untreated OSA in children with DS, such as cardiovascular and neurobehavioral consequences, more robust randomized trials in this patient population are needed to produce treatment guidelines separate from those for the general pediatric population of otherwise healthy children with OSA. Further studies are also needed to look at desensitization and optimization of CPAP use in patients with DS and OSA.

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The prevalence of obstructive sleep apnea in symptomatic patients with syndromic craniosynostosis

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2015.10.003 ◽

2016 ◽

Vol 45 (2) ◽

pp. 167-169 ◽

Cited By ~ 21

Author(s):

G. Inverso ◽

K.A. Brustowicz ◽

E. Katz ◽

B.L. Padwa

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Syndromic Craniosynostosis ◽

Obstructive Sleep

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Reliability and validity testing of automated scoring in obstructive sleep apnea diagnosis with the embletta x100

Sleep Medicine ◽

10.1016/j.sleep.2017.11.739 ◽

2017 ◽

Vol 40 ◽

pp. e252-e253

Author(s):

D.-Y. Park ◽

H.J. Kim ◽

S.M. In

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Reliability And Validity ◽

Automated Scoring ◽

Validity Testing ◽

Obstructive Sleep

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Retropalatal Cross-Sectional Area Is Predictive of Obstructive Sleep Apnea in Patients With Syndromic Craniosynostosis

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619882571 ◽

2019 ◽

Vol 57 (5) ◽

pp. 560-565 ◽

Cited By ~ 1

Author(s):

Cory M. Resnick ◽

Jason K. Middleton ◽

Carly E. Calabrese ◽

Karan Ganjawalla ◽

Bonnie L. Padwa

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Upper Airway ◽

Cross Sectional Area ◽

Secondary Outcome ◽

Outcome Variable ◽

Sectional Area ◽

Cross Sectional ◽

Syndromic Craniosynostosis ◽

Obstructive Sleep

Objective: There is a high rate of obstructive sleep apnea (OSA) in patients with syndromic craniosynostosis (SCS). Little is known about the airway anatomy in this population. The purpose of this study is to characterize the 3 dimensional (3D) upper airway in patients with SCS with and without OSA. Design: This is a retrospective study of patients with SCS treated at Boston Children’s Hospital from 2000 to 2015. Patients were divided into OSA and no-OSA groups based on polysomnography. Predictor variables included age, sex, body mass index (BMI), and 3D upper airway measurements. The primary outcome variable was the presence or absence of OSA. Secondary outcome variables were apnea–hypopnea index and oxygen saturation nadir. Descriptive and bivariate statistics were computed, and significance was set as P < .05. Results: There were 24 patients: 16 in the OSA group and 8 in the no-OSA group. The 2 groups did not differ significantly by age, BMI, or syndromic diagnosis. The presence of OSA was associated with a smaller minimum retropalatal cross-sectional area (minRPCSA; P < .001). In a logistic regression model controlling for age, sex, and upper airway length, minRPCSA was the primary predictor of OSA ( P ≤ .002). Receiver operating characteristic analysis determined minRPCSA = 55.3 mm2 to be the optimal diagnostic threshold for OSA, with sensitivity = 100% and specificity = 87.5% ( P < .001). Conclusion: A minRPCSA ≤55.3 mm2 is predictive of the presence of OSA in patients with SCS.

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Obstructive sleep apnea in children aged 3 years and younger: Rate and risk factors

Paediatrics & Child Health ◽

10.1093/pch/pxz097 ◽

2019 ◽

Vol 25 (7) ◽

pp. 432-438

Author(s):

Sarah Selvadurai ◽

Giorge Voutsas ◽

Evan J Propst ◽

Nikolaus E Wolter ◽

Indra Narang

Keyword(s):

Risk Factors ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Nasal Congestion ◽

Retrospective Chart Review ◽

Binary Logistic Regression ◽

High Rate ◽

Binary Logistic Regression Analysis ◽

Healthy Children ◽

Obstructive Sleep

Abstract Objective Undiagnosed and untreated obstructive sleep apnea (OSA) can predispose children to neurobehavioural consequences. However, there is a lack of data identifying rate of, and risk factors for, OSA in very young healthy children. The objective of this study was to determine the rate of OSA and identify risk factors associated with the presence and severity of OSA in children aged 3 years and younger. Methods This was a retrospective chart review of healthy children between 1 and 3 years old who had a baseline polysomnogram (PSG) between January 2012 and June 2017. Patient demographics, referral history, and PSG data were recorded. Results One hundred and thirteen children were referred for a PSG, of which 66 (58%) were diagnosed with OSA and 47 (42%) did not have OSA. In the OSA group, 13 (20%) were mild and 53 (80%) were moderate-severe. Nasal congestion (P=0.001), adenoid hypertrophy (P=<0.001), and tonsillar hypertrophy (P=0.04) reported at the time of referral were more common in the OSA group compared to the no-OSA group. Binary logistic regression analysis showed that referral from an otolaryngologist (odds ratio=2.6, 95% confidence interval=1.1 to 6.0) were associated with moderate-severe OSA. Conclusion A high rate of OSA was found among children aged 3 years and younger. Children referred by an otolaryngologist are more likely to be diagnosed with moderate-severe OSA. Children aged 3 years and younger with symptoms of OSA should be considered high-risk for OSA and be prioritized for early PSG and management.

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Upper Airway Length is Predictive of Obstructive Sleep Apnea in Syndromic Craniosynostosis

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2015.04.017 ◽

2015 ◽

Vol 73 (12) ◽

pp. S20-S25 ◽

Cited By ~ 9

Author(s):

Kelley Dentino ◽

Karan Ganjawalla ◽

Gino Inverso ◽

John B. Mulliken ◽

Bonnie L. Padwa

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Upper Airway ◽

Syndromic Craniosynostosis ◽

Obstructive Sleep

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Neuropsychological effects of pediatric obstructive sleep apnea

Journal of the International Neuropsychological Society ◽

10.1017/s135561770410708x ◽

2004 ◽

Vol 10 (7) ◽

pp. 962-975 ◽

Cited By ~ 120

Author(s):

DEAN W. BEEBE ◽

CAROLYN T. WELLS ◽

JENNIFER JEFFRIES ◽

BARBARA CHINI ◽

MANINDER KALRA ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Verbal Memory ◽

Neuropsychological Functioning ◽

Parent Report ◽

Healthy Children ◽

Behavioral Impairment ◽

School Aged Children ◽

Neuropsychological Effects ◽

Obstructive Sleep

Obstructive sleep apnea (OSA) is a fairly common nocturnal breathing disorder, affecting 2–4% of individuals. Although OSA is associated with medical morbidity, its most functionally disruptive effects in adults appear to be neuropsychological in nature. Research on the neuropsychological effects of pediatric OSA has been limited. This study compared the neuropsychological functioning of school-aged children with OSA to that of healthy children. The primary goal was to clarify the presence and pattern of neuropsychological morbidity associated with pediatric OSA. Sleep was assessed with parent-report questionnaires and laboratory sleep studies. Neuropsychological functioning was assessed by formal tests and parent- and teacher-report questionnaires. Data indicated OSA-related cognitive and behavioral impairment that was particularly marked on measures of behavior regulation and some aspects of attention and executive functioning. Minimal effects were observed on measures of intelligence, verbal memory, or processing speed. Exploratory analyses failed to indicate any clear relationship between neuropsychological functioning and objective indexes of hypoxia or sleep disruption, though the sample was small. These data add to a growing literature which suggests that significant neuropsychological deficits are associated with pediatric OSA. Findings suggest a pattern of neuropsychological morbidity that is similar but not identical to that seen in adult OSA. (JINS, 2004, 10, 962–975.)

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