scholarly journals Inflammatory Markers and Obstructive Sleep Apnea in Obese Children: The NANOS Study

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Alex Gileles-Hillel ◽  
María Luz Alonso-Álvarez ◽  
Leila Kheirandish-Gozal ◽  
Eduard Peris ◽  
José Aurelio Cordero-Guevara ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Inflammatory Markers ◽  
Sleep Apnea Syndrome ◽  
Community Dwelling ◽  
Low Grade ◽  
Obese Children ◽  
Blood Draw ◽  
Obstructive Sleep ◽  
Pai 1

Introduction.Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities.Aim.To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables.Methods.In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4–15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers.Results.204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI) of 3 events/hour total sleep time (TST). BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST;P<0.01), while MCP-1 levels were associated with more prolonged nocturnal hypercapnia(P<0.001).Conclusion.IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.govNCT01322763.

scholarly journals Metabolic alterations and systemic inflammation in overweight/obese children with obstructive sleep apnea

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252353
Author(s):  
Surya Prakash Bhatt ◽  
Randeep Guleria ◽  
S. K. Kabra
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Systemic Inflammation ◽  
Inflammatory Markers ◽  
Fasting Insulin ◽  
Obese Children ◽  
Obstructive Sleep ◽  
Tnf Α ◽  
Hs Crp ◽  
Pai 1

Aim and objective Systemic inflammation has been documented in obstructive sleep apnea (OSA). However studies on childhood OSA and systemic inflammation are limited. This study aimed to determine the relation between OSA in overweight/obese children and various inflammatory markers. Material and methods In this cross sectional study, we enrolled 247 overweight/ obese children from pediatric outpatient services. We evaluated demographic and clinical details, anthropometric parameters, body composition and estimation of inflammatory cytokines such as interleukin (IL) 6, IL-8, IL-10, IL-17, IL-18, IL-23, macrophage migration inhibitory factor (MIF), high sensitive C-reactive protein (Hs-CRP), tumor necrosis factor-alpha (TNF-α), plasminogen activator inhibitor-1 (PAI-1) and leptin levels. Overnight polysomnography was performed. Findings A total of 247 children (190 with OSA and 57 without OSA) were enrolled. OSA was documented on polysomnography in 40% of patients. We observed significantly high values body mass index, waist circumference (WC), % body fat, fasting blood glucose (FBG), alanine transaminase (ALT), alkaline phosphate, fasting insulin and HOMA-IR in children with OSA. Inflammatory markers IL-6, IL-8, IL-17, IL-18, MIF, Hs CRP, TNF- α, PAI-1, and leptin levels were significantly higher in OSA patients (p<0.05). There was strong positive correlation of IL-6, IL-8, IL-17, IL-23, MIF, Hs CRP, TNF-A, PAI-1 and leptin with BMI, % body fat, AHI, fasting Insulin, triglyceride, FBG, WC, HOMA-IR, AST and ALT. Conclusion Children with OSA have increased obesity, insulin resistance and systemic inflammation. Further studies are require to confirm our findings and evaluate their utility in diagnosis of OSAs, assessing severity and possible interventions.

scholarly journals Obstructive Sleep Apnea and Inflammation: Proof of Concept Based on Two Illustrative Cytokines

2019 ◽  
Vol 20 (3) ◽  
pp. 459 ◽  
Author(s):  
Leila Kheirandish-Gozal ◽  
David Gozal
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Inflammatory Diseases ◽  
Sleep Apnea Syndrome ◽  
Special Focus ◽  
Normal Body Mass Index ◽  
Low Grade ◽  
Obstructive Sleep ◽  
Inflammatory Processes ◽  
Factor Α

Obstructive sleep apnea syndrome (OSAS) is a markedly prevalent condition across the lifespan, particularly in overweight and obese individuals, which has been associated with an independent risk for neurocognitive, behavioral, and mood problems as well as cardiovascular and metabolic morbidities, ultimately fostering increases in overall mortality rates. In adult patients, excessive daytime sleepiness (EDS) is the most frequent symptom leading to clinical referral for evaluation and treatment, but classic EDS features are less likely to be reported in children, particularly among those with normal body-mass index. The cumulative evidence collected over the last two decades supports a conceptual framework, whereby sleep-disordered breathing in general and more particularly OSAS should be viewed as low-grade chronic inflammatory diseases. Accordingly, it is assumed that a proportion of the morbid phenotypic signature in OSAS is causally explained by underlying inflammatory processes inducing end-organ dysfunction. Here, the published links between OSAS and systemic inflammation will be critically reviewed, with special focus on the pro-inflammatory cytokines tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), since these constitute classical prototypes of the large spectrum of inflammatory molecules that have been explored in OSAS patients.

Effectiveness of Intranasal Sodium Hyaluronate in Mitigating Adverse Effects of Nasal Continuous Positive Airway Pressure Therapy

2017 ◽  
Vol 31 (6) ◽  
pp. 364-369 ◽  
Author(s):  
Ignazio La Mantia ◽  
Claudio Andaloro
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Inflammatory Markers ◽  
Mucociliary Clearance ◽  
Saline Solution ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Sodium Hyaluronate ◽  
Obstructive Sleep ◽  
Nasal Mucociliary Clearance

Background Nasal continuous positive airway pressure (CPAP) in moderate-to-severe cases of obstructive sleep apnea can cause nasal discomfort and other undesirable problems. Objective The aim of our study was to test the effects of sodium hyaluronate on nasal problems that patients experienced in their daily lives, sleepiness, nasal resistance to airflow, nasal mucociliary clearance, changes in inflammatory markers, and compliance to CPAP in three groups of patients with obstructive sleep apnea syndrome on CPAP therapy. Methods A total of 102 patients with a confirmed diagnosis of obstructive sleep apnea syndrome (apnea-hypopnea index [AHI] of ≥10/hour) were randomized into three treatment groups: (1) hyaluronate plus CPAP, (2) saline solution plus CPAP, and (3) CPAP-only groups. Outcome measures were the extent of improvement in the Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) mean scores, sleepiness, nasal resistance to airflow, nasal mucociliary clearance, changes in inflammatory markers, and compliance to CPAP. Significant improvement in each outcome measure was determined by comparing scores at baseline and after 4 weeks for each treatment group. Results Significant improvement in the MiniRQLQ overall mean score was observed both in the hyaluronate plus CPAP (p <0.00001) and saline solution plus CPAP groups (p <0.01), although the hyaluronate plus CPAP group had better improvement compared with the saline solution plus CPAP group (0.24 versus 0.12, respectively). An increase in nasal inflammatory markers and saccharin transit test score was observed in all three groups, although it was statistically lower in the hyaluronate plus CPAP group (all p <0.001). Conclusion Intranasal hyaluronate showed significant benefits in patients who received CPAP therapy, but future studies over a longer period of time after treatment should be performed to corroborate our findings.

scholarly journals Management of Obstructive Sleep Apnea Syndrome in Obese Children

2013 ◽  
Vol 1 (3) ◽  
Author(s):  
Vina Rosalina ◽  
Maria Mexitalia ◽  
Dwi Wastoro
Keyword(s):  
Obstructive Sleep Apnea ◽  
Hearing Loss ◽  
Sleep Apnea ◽  
Conductive Hearing Loss ◽  
Severe Hypertension ◽  
Sleep Apnea Syndrome ◽  
Obese Children ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Conductive Hearing

Background : Obstructive Sleep Apnea Syndrome (OSAS) is strongly associated with obesity. The common presenting complaints are excessive daytime sleepiness and loud snoring which potential for significant comorbidity of metabolic syndrome and decreasing in quality of life. Case : An 11-year-old obese boy was refereed to Dr. Kariadi Hospital with complaints of fatique and frontal headache. His mother reported the loud snoring, apneic events during the night, excessive daytime sleepiness, increased irritability, and difficulty of school learning. Imaging studies showed cardiomegaly, adenoidal/nasopharyngeal ratio 0.714; opaque mass on cervical and airway space narrowing. Tympanometric audiogram showed mild right conductive hearing loss. The patient was diagnosed with OSAS, chronic and hypertrophic adenotonsillitis, severe hypertension, dilated right ventricle, right conductive hearing loss, obesity. The boy was undergone adenotonsillectomy and management of weight lossed. Antihipertensive and other supportive medication were given and good results. Discussion : The recommended initial treatment, even in obese children, consists of surgical removal of the adenoids and tonsils.5,6 Several studies have shown that adenotonsillectomy reverses the symptoms and confirm the beneficial effects for OSAS on children's growth, school performance, improvements in PSG, behavior, QoL and cardiac function. The success rate for adenotonsillectomy in the context of OSA was approximately 85%. Conclusion : Adenotonsillectomy and weight reduction is considered to be the primary intervention for OSAS children. Because the case had also severe hypertension, antihypertensive and other supportive medicine were give and had a good result. Keywords : OSAS, obesity, children, adenotonsillectomy  

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 Adenotonsillectomy in Obese Children with Obstructive Sleep Apnea Syndrome: Magnetic Resonance Imaging Findings and Considerations

SLEEP ◽  
2013 ◽  
Vol 36 (6) ◽  
pp. 841-847 ◽  
Author(s):  
Kiran Nandalike ◽  
Keivan Shifteh ◽  
Sanghun Sin ◽  
Temima Strauss ◽  
Allison Stakofsky ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Magnetic Resonance ◽  
Sleep Apnea Syndrome ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Obese Children ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Childhood Obesity and Respiratory Diseases: Which Link?

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 177
Author(s):  
Emanuela di di Palmo ◽  
Emanuele Filice ◽  
Alessandra Cavallo ◽  
Carlo Caffarelli ◽  
Giulio Maltoni ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Childhood Obesity ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Respiratory Diseases ◽  
Sleep Apnea Syndrome ◽  
Environment Interaction ◽  
Obese Children ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Prevalence of childhood obesity is progressively increasing, reaching worldwide levels of 5.6% in girls and of 7.8% in boys. Several evidences showed that obesity is a major preventable risk factor and disease modifier of some respiratory conditions such as asthma and Obstructive Sleep Apnea Syndrome (OSAS). Co-occurrence of asthma and obesity may be due to common pathogenetic factors including exposure to air pollutants and tobacco smoking, Western diet, and low Vitamin D levels. Lung growth and dysanapsis phenomenon in asthmatic obese children play a role in impaired respiratory function which appears to be different than in adults. Genes involved in both asthma and obesity have been identified, though a gene-by-environment interaction has not been properly investigated yet. The identification of modifiable environmental factors influencing gene expression through epigenetic mechanisms may change the natural history of both diseases. Another important pediatric respiratory condition associated with obesity is Sleep-Disordered Breathing (SDB), especially Obstructive Sleep Apnea Syndrome (OSAS). OSAS and obesity are linked by a bidirectional causality, where the effects of one affect the other. The factors most involved in the association between OSAS and obesity are oxidative stress, systemic inflammation, and gut microbiota. In OSAS pathogenesis, obesity’s role appears to be mainly due to mechanical factors leading to an increase of respiratory work at night-time. However, a causal link between obesity-related inflammatory state and OSAS pathogenesis still needs to be properly confirmed. To prevent obesity and its complications, family education and precocious lifestyle changes are critical. A healthy diet may lead to an improved quality of life in obese children suffering from respiratory diseases. The present review aimed to investigate the links between obesity, asthma and OSAS, focusing on the available evidence and looking for future research fields.

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