Respiratory cortical processing to inspiratory resistances during wakefulness in children with the obstructive sleep apnea syndrome

Children with the obstructive sleep apnea syndrome (OSAS) have impaired respiratory afferent cortical processing during sleep that persists after treatment of OSAS. However, it is unknown whether this impairment is present during wakefulness and, if so, whether it improves after OSAS treatment. We hypothesized that children with OSAS, during wakefulness, have abnormal cortical processing of respiratory stimuli manifested by blunted respiratory-related evoked potentials (RREP) and that this resolves after OSAS treatment. We measured RREP during wakefulness in 26 controls and 21 children with OSAS before and after treatment. Thirteen participants with OSAS repeated testing 3–6 mo after adenotonsillectomy. RREP were elicited by interruption of inspiration by total occlusion and 30 and 20 cmH2O/l per s resistances. Nf at Fz latency elicited by occlusion was longer in children with OSAS at baseline compared with controls (78.8 ± 24.8 vs. 63.9 ± 19.7 ms, P = 0.05). All other peak amplitudes and latencies were similar between the two groups. After OSAS treatment, Nf at Fz latency elicited by 30 cmH2O/l per s decreased significantly (before, 88 ± 26 vs. after, 71 ± 25 ms, P = 0.02), as did that elicited by 20 cmH2O/l per s (85 ± 27 vs. 72 ± 24 ms, P = 0.004). The amplitude of N1 at Cz elicited by occlusion increased from −3.4 ± 5.6 to −7.4 ± 3 μV ( P = 0.049) after treatment. We concluded that children with OSAS have partial delay of respiratory afferent cortical processing during wakefulness that improves after treatment.

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Efficacy of Rapid Maxillary Expansion with or without Previous Adenotonsillectomy for Pediatric Obstructive Sleep Apnea Syndrome Based on Polysomnographic Data: A Systematic Review and Meta-Analysis

Applied Sciences ◽

10.3390/app10186485 ◽

2020 ◽

Vol 10 (18) ◽

pp. 6485

Author(s):

Vincenzo Quinzi ◽

Sabina Saccomanno ◽

Rebecca Jewel Manenti ◽

Silvia Giancaspro ◽

Licia Coceani Paskay ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Meta Analysis ◽

Sleep Apnea Syndrome ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Obstructive Sleep ◽

Before And After ◽

Apnea Syndrome

Aim: To systematically review international literature related to rapid maxillary expansion (RME) as the treatment for obstructive sleep apnea syndrome (OSAS) in children less than 18 years-old, followed by a meta-analysis of the apnea-hypopnea index (AHI) before and after RME, with or without a previous adenotonsillectomy (AT). Methods: Literature on databases from PubMed, Wiley online library, Cochrane Clinical Trials Register, Springer link, and Science Direct were analyzed up to March 2020. Two independent reviewers (S.G. and R.J.M.) screened, assessed, and extracted the quality of the publications. A meta-analysis was performed to compare AHI values before and after the treatment with RME. Results: Six studies reported outcomes for 102 children with a narrow maxillary arch suffering from OSAS with a mean age of 6.7 ± 1.3. AHI improved from a M ± SD of 7.5 ± 3.2/h to 2.5 ± 2.6/h. A higher AHI change in patients with no tonsils (83.4%) and small tonsils (97.7%) was detected when compared to children with large tonsils (56.4%). Data was analyzed based on a follow-up duration of ≤3 year in 79 children and >3 years in 23 children. Conclusion: Reduction in the AHI was detected in all 102 children with OSAS that underwent RME treatment, with or without an adenotonsillectomy. Additionally, a larger reduction in the AHI was observed in children with small tonsils or no tonsils. A general improvement on the daytime and nighttime symptoms of OSAS after RME therapy was noted in all the studies, demonstrating the efficacy of this therapy.

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Mandibular-Lingual Repositioning Device - MLRD: preliminary results of 8 patients with Obstructive Sleep Apnea Syndrome - OSAS

Sao Paulo Medical Journal ◽

10.1590/s1516-31801995000300002 ◽

1995 ◽

Vol 113 (3) ◽

pp. 888-894

Author(s):

Ricardo Castro Barbosa ◽

Flávio Aloe ◽

Stella Tavares ◽

Ademir Baptista Silva

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Epworth Sleepiness Scale ◽

Sleep Apnea Syndrome ◽

Preliminary Results ◽

Statistical Variation ◽

Obstructive Sleep ◽

Before And After ◽

Apnea Syndrome

Dental devices have been employed in the treatment of snoring and obstructive sleep apnea syndrome (OSAS) of mild to moderate degrees. The authors disclose the preliminary results in 8 patients with clinically diagnosed obstructive sleep apnea polisomnographically confirmed and treated with a dental device (Mandibular-Lingual Repositioning Device - MLRD) developed by one of the authors (RCB). Cephalometrics was performed before usage of MLRD, Epworth Sleepiness Scale (ESS) tests were conducted before and after the MLRD and a questionnaire that subjectively qualified the Overall Subjective Improvement of the patient (OSI) was filled out. The tests were repeated 4 weeks after the application of the MLRD. The average subjective overall improvement was 73.75% and the Epworth Sleepiness Scale was 13.88 (pre - MLRD) and 6.63 (post - MLRD) representing a significant statistical variation (p=0.05). The authors discuss probable factors involved in the improvement of the subjective measurements of excessive sleepiness.

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ENDOTHELIAL DYSFUNCTION MARKERS BEFORE AND AFTER CPAP TREATMENT IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME

Atherosclerosis Supplements ◽

10.1016/s1567-5688(08)70277-0 ◽

2008 ◽

Vol 9 (1) ◽

pp. 69-70

Author(s):

O.K. Nikitidou ◽

E.G. Daskalopoulou ◽

E.G. Vlachogiannis ◽

E.K. Kosmidou ◽

E.K. Mastrogiannidou ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Endothelial Dysfunction ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Cpap Treatment ◽

Obstructive Sleep ◽

Before And After ◽

Apnea Syndrome

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Plasma levels of TNF in obstructive sleep apnea syndrome (OSA) before and after surgical intervention

Egyptian Journal of Chest Diseases and Tuberculosis ◽

10.1016/j.ejcdt.2012.10.024 ◽

2012 ◽

Vol 61 (3) ◽

pp. 179-185 ◽

Cited By ~ 2

Author(s):

Eman Reyad ◽

Nancy Mahmoud Abdelaty ◽

Mahmoud El Prince ◽

Alaa Farid ◽

Mohamed K. El- Serougy

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Plasma Levels ◽

Surgical Intervention ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Before And After ◽

Apnea Syndrome

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Evaluation of neurocognitive abilities in children affected by obstructive sleep apnea syndrome before and after adenotonsillectomy

Acta Otorhinolaryngologica Italica ◽

10.14639/0392-100x-n0267 ◽

2020 ◽

Vol 40 (2) ◽

pp. 122-132 ◽

Cited By ~ 1

Author(s):

Domenico Testa ◽

Marco Carotenuto ◽

Francesco Precenzano ◽

Alessia Russo ◽

Anna Donadio ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Before And After ◽

Apnea Syndrome

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The Results of Uvulopalatopharyngoplasty in Patients with Moderate Obstructive Sleep Apnea Syndrome Having Cardiac Arrhythmias

Multidisciplinary Cardiovascular Annals ◽

10.5812/mca.103810 ◽

2020 ◽

Vol 11 (2) ◽

Author(s):

Ali Seyed Resuli ◽

Hasan Samur

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Cardiac Arrhythmias ◽

Sinus Bradycardia ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Before And After ◽

Cardiology Clinic ◽

Apnea Syndrome

Objectives: The goal of this practice was to explore whether the changes in arrhythmias after uvulopalatopharyngoplasty (UPPP) in patients with moderate obstructive sleep apnea syndrome (OSAS) who continued cardiac arrhythmias despite the use of antiarrhythmic drugs and those who could not tolerate the continuous positive airway pressure (CPAP) device. In addition, we evaluated the correlation between arrhythmias before and after UPPP. Methods: This retrospective study included patients who have OSAS and cardiac arrhythmias, between 2008 - 2017 by the cardiology clinic and consulted by the ear, nose, and throat (ENT) clinic. Thirty eight patients were selected and underwent UPPP operation. The rhythm Holter follow-ups of the patients in the 1st month before UPPP (pre-UPPP) and after UPPP (post-UPPP) 6th month were performed. The recordings were transferred to the computer and evaluated with the Holter program, then visually examined and the parasitic regions were excluded. Sinus bradycardia (SB), atrioventricular block (AVB), atrial premature beat (APB), supraventricular tachycardia (SVT), and ventricular extrasystole (VES) parameters were recorded for arrhythmia. Results: Statistically significant differences were observed in the changes in SB, AVB, APB, SVT and VE arrhythmia values in pre-UPPP and post-UPPP periods. Also, in one case the values of arrhythmia in the pre-UPPP period had a positive correlation with the values of the same arrhythmia in the post-UPPP period (P < 0.001). Conclusions: In this study, new information about the effects of UPPP which is one of OSAS treatment methods on cardiac arrhythmias is presented. According to our results, UPPP reduces the rate of SB, AVB, APB, SVT and VES arrhythmias in OSAS patients.

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