scholarly journals Childhood Obesity and Obstructive Sleep Apnea

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Indra Narang ◽  
Joseph L. Mathew
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Early Recognition ◽  
Upper Airway ◽  
Systemic Hypertension ◽  
Childhood And Adolescence ◽  
Obese Children ◽  
Metabolic Systems ◽  
Obstructive Sleep ◽  
Increased Risk

The global epidemic of childhood and adolescent obesity and its immediate as well as long-term consequences for obese individuals and society as a whole cannot be overemphasized. Obesity in childhood and adolescence is associated with an increased risk of adult obesity and clinically significant consequences affecting the cardiovascular and metabolic systems. Importantly, obesity is additionally complicated by obstructive sleep apnea (OSA), occurring in up to 60% of obese children. OSA, which is diagnosed using the gold standard polysomnogram (PSG), is characterised by snoring, recurrent partial (hypopneas) or complete (apneas) obstruction of the upper airway. OSA is frequently associated with intermittent oxyhemoglobin desaturations, sleep disruption, and sleep fragmentation. There is emerging data that OSA is associated with cardiovascular burden including systemic hypertension, changes in ventricular structure and function, arterial stiffness, and metabolic syndromes. Thus, OSA in the context of obesity may independently or synergistically magnify the underlying cardiovascular and metabolic burden. This is of importance as early recognition and treatment of OSA in obese children are likely to result in the reduction of cardiometabolic burden in obese children. This paper summarizes the current state of understanding of obesity-related OSA. Specifically, this paper will discuss epidemiology, pathophysiology, cardiometabolic burden, and management of obese children and adolescents with OSA.

scholarly journals Clinicals and upper airway characteristics in obese children with obstructive sleep apnea

Sleep Science ◽  
2017 ◽  
Author(s):  
Eli Onivaldo Martinelli ◽  
Fernanda Louise Martinho Haddad ◽  
Renato Stefanini ◽  
Gustavo Antonio Moreira ◽  
Priscila Bogar Rapoport ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Obese Children ◽  
Obstructive Sleep

scholarly journals Effects of Inhaled Corticosteroids and Particle Size on Risk of Obstructive Sleep Apnea: A Large Retrospective Cohort Study

2020 ◽  
Vol 17 (19) ◽  
pp. 7287
Author(s):  
Maria Paula Henao ◽  
Jennifer L. Kraschnewski ◽  
Matthew D. Bolton ◽  
Faoud Ishmael ◽  
Timothy Craig
Keyword(s):  
Particle Size ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Fine Particle ◽  
Inhaled Corticosteroids ◽  
Multivariate Logistic Regression Analysis ◽  
Upper Airway ◽  
Act Scores ◽  
Obstructive Sleep ◽  
Increased Risk

Background: Inhaled corticosteroids (ICS) produce local effects on upper airway dilators that could increase the risk of developing obstructive sleep apnea (OSA). Given that the particle size of ICS changes their distribution, the particle size of ICS may impact the risk of developing OSA. Objectives: In this large retrospective study, we explore the relationship of ICS use and OSA in patients with asthma. In addition, we seek to determine if this relationship is affected by the particle size of ICS. Methods: Using electronic health records, we established a cohort of 29,816 asthmatics aged 12 and older with a diagnosis of asthma documented by ICD-9 or ICD-10 codes between January 2011 and August 2016. We performed analyses of variance and multivariate logistic regression analysis to determine the effects ICS on the diagnosis of OSA with sub-analysis by particle size of ICS. Results: Uncontrolled asthmatics showed increased odds of receiving a diagnosis of OSA whether when looking at ACT scores (adjusted odds ratio (aOR) 1.60, 95% CI 1.32–1.94) or PFT results (aOR 1.45, 95% CI 1.19–1.77). Users of ICS also had increased odds of OSA independent of asthma control (aOR 1.58, 95% CI 1.47–1.70). Notably, users of extra-fine particle ICS did not have significantly increased odds of having OSA compared to non-users of ICS (aOR 1.11, 95% CI 0.78–1.58). Conclusions: Use of ICS appears to be an independent risk factor for OSA. Notably, extra-fine particle size ICS do not appear to be associated with an increased risk of OSA.

Hypoglossal nerve stimulation [HGNS] for Obstructive Sleep Apnea [OSA] treatment – a review

2017 ◽  
Vol 6 (3) ◽  
pp. 66-71
Author(s):  
Małgorzata Bilińska ◽  
Kazimierz Niemczyk
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hypoglossal Nerve ◽  
Muscle Tone ◽  
Upper Airway ◽  
Western Society ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Osa Treatment ◽  
Oncologic Diseases

Obstructive sleep apnea (OSA) is characterized by recurrent periods of upper airway obstruction (hypopneas and apneas) during sleep. It leads to repeated oxyhemoglobin desaturations, nocturnal hypercapnia, and arousals. Common symptoms include loud snoring with breathing interruptions. Excessive daytime sleepiness and cognitive impairment occur. Obstructive sleep apnea is a major cause of morbidity and mortality in Western society. Its association with an increased risk of development and progression of neurocognitive, metabolic, cardiovascular and oncologic diseases and complications is well described. The significant factor in OSA pathogenesis is reduced muscle tone in the tongue and upper airway. In the recent years, devices providing neurostimulation of the hypoglossal nerve (HGNS) were developed as an alternative for noncompliant CPAP (continuous positive airway pressure) patients. Clinical trials suggest that electrical stimulation of the hypoglossal nerve is effective. This is considered to be one of the targets of neurostimulation in the treatment of obstructive sleep apnea (OSA).

scholarly journals MR Image Analytics to Characterize the Upper Airway Structure in Obese Children with Obstructive Sleep Apnea Syndrome

PLoS ONE ◽  
2016 ◽  
Vol 11 (8) ◽  
pp. e0159327 ◽  
Author(s):  
Yubing Tong ◽  
Jayaram K. Udupa ◽  
Sanghun Sin ◽  
Zhengbing Liu ◽  
E. Paul Wileyto ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Obese Children ◽  
Mr Image ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Upper Airway Structure

scholarly journals The Association between Use of Benzodiazepine Receptor Agonists and the Risk of Obstructive Sleep Apnea: A Nationwide Population-Based Nested Case-Control Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9720
Author(s):  
Tien-Wei Hsu ◽  
Hsiu-Min Chen ◽  
Tien-Yu Chen ◽  
Che-Sheng Chu ◽  
Chih-Chuan Pan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cumulative Dose ◽  
Drug Users ◽  
Muscle Relaxation ◽  
Upper Airway ◽  
Benzodiazepine Receptor ◽  
Receptor Agonists ◽  
Obstructive Sleep ◽  
Increased Risk

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway collapse. Benzodiazepine receptor agonists (BZRAs) are associated with pharyngeal muscle relaxation, increased apnea duration, and hypoxia, which might worsen OSA. This study aimed to examine the association between the use of BZRAs and the risk of OSA. The study was conducted using data from the National Health Insurance Database of Taiwan between 2002 and 2011. We only included new users who were never exposed to any BZRAs and identified 1848 participants with OSA, and 1848 matched controls. A logistic regression model was used to determine the association between the use of BZRAs and the development of OSA. BZRA exposure was divided into usage patterns, dosage, duration, and pharmacokinetic class. We found an increased risk of OSA in current users and recent past users compared with distant past users. Patients with a higher cumulative dose of BZRAs were more likely to develop OSA compared to those with a lower cumulative dose. We found an increased risk of OSA in patients treated with BZRAs, especially for current users and those with higher cumulative doses. A reduced risk of OSA was found in Z-drug users compared with benzodiazepine users.

The Prevalence and Impact of Obstructive Sleep Apnea and Current Management Landscape

2021 ◽  
pp. 5-26
Author(s):  
Kevin Motz ◽  
Susheel P. Patil
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Surgical Approaches ◽  
Pressure Therapy ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Male Sex ◽  
New Treatment ◽  
Surgical Treatments

Obstructive sleep apnea (OSA) is characterized by repeated collapse of the upper airway during sleep that leads to reduced airflow and oxyhemoglobin desaturation. The disorder is highly prevalent, with obesity, male sex, and increasing age as risk factors. Consequences of untreated OSA include neurocognitive impairment, such as excessive daytime sleepiness, and an increased risk of cardiovascular and cerebrovascular disease. Positive airway pressure therapy remains the most common treatment for OSA. Over the last few decades, alternative nonsurgical and surgical treatments have been developed. Although surgical approaches are rarely curative, careful patient selection may benefit a subpopulation of people living with OSA. Selective hypoglossal nerve stimulation represents a new treatment strategy for the management of OSA in selected patients.

Using the pathophysiology of obstructive sleep apnea to teach cardiopulmonary integration

2008 ◽  
Vol 32 (3) ◽  
pp. 196-202 ◽  
Author(s):  
Michael G. Levitzky
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Blood Gases ◽  
Upper Airway Obstruction ◽  
Systemic Hypertension ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is a common disorder of upper airway obstruction during sleep. The effects of intermittent upper airway obstruction include alveolar hypoventilation, altered arterial blood gases and acid-base status, and stimulation of the arterial chemoreceptors, which leads to frequent arousals. These arousals disturb sleep architecture and cause hypersomnolence. Chronic intermittent alveolar and systemic arterial hypoxia-hypercapnia can cause pulmonary and systemic hypertension, with effects on the right and left ventricles, and even the renal system. The pathophysiology of OSA can therefore be used to review and integrate many topics in pulmonary and cardiovascular physiology in the context of problem-based learning, a guided discussion, or a formal lecture. The discussion begins with a case scenario, followed by a definition of the disorder, the common symptoms and signs of OSA, and a description of an apneic event. These are related to the physiology of the upper airway in OSA, normal alterations in the respiratory system during sleep, the effects of apnea on gas exchange and arterial blood gases, and the cardiovascular consequences of alterations in alveolar and systemic arterial Po2 and Pco2. The treatment of OSA, particularly how the use of continuous positive airway pressure relates to the pathophysiology of the disorder, is discussed briefly.

scholarly journals Clinicals And Upper Airway Characteristics in Obese Children with Obstructive Sleep Apnea

Sleep Science ◽  
2017 ◽  
Vol 10 (1) ◽  
Author(s):  
Eli O Martinelli ◽  
Fernanda Louise M Haddad ◽  
Renato Stefanini ◽  
Gustavo A Moreira ◽  
Priscila B Rapoport ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Obese Children ◽  
Obstructive Sleep
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