Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

2009 ◽  
Vol 46 (2) ◽  
pp. 117-123 ◽  
Author(s):  
J. E. MacLean ◽  
K. Waters ◽  
D. Fitzsimons ◽  
P. Hayward ◽  
D. A. Fitzgerald
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Preschool Children ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Clinical Risk Factor ◽  
Questionnaire Data ◽  
Clinical Risk ◽  
Obstructive Sleep

Objective: The objective of this study was to explore the prevalence, range of reported symptoms, and clinical risk factors of obstructive sleep apnea in preschool children with cleft lip and/or palate. Design: Questionnaires were distributed to parents/guardians of all children from birth to 5 years of age who were followed by the cleft clinic. Results: Questionnaire data and cleft classification were available for 248 children, with a mean age of 33.4 months. Obstructive sleep apnea was identified in 31.4% of the children. Only 29.5% of children with obstructive sleep apnea had undergone an investigation of these symptoms. The three most common symptoms reported in children with a questionnaire diagnosis of obstructive sleep apnea were (1) “heavy or loud breathing,” (2) “easily distracted,” and (3) “on the go” or “driven by a motor.” The only clinical risk factor associated with a questionnaire diagnosis of obstructive sleep apnea was the presence of a syndrome (χ2  =  3.5, p  =  .05). There were no significant differences in risk of obstructive sleep apnea by age, cleft classification, and surgical status. Conclusion: Preschool children with cleft lip and/or palate have a risk of obstructive sleep apnea that is as much as five times that of children without cleft. Obstructive sleep apnea appears to be underrecognized in this group of children. Further research is needed to investigate important risk factors for obstructive sleep apnea in children with cleft lip and/or palate.

scholarly journals Interrelation between Sleep Bruxism and Obstructive Sleep Apnea: Literature Review

2021 ◽  
pp. 322-329
Author(s):  
Nabiel Alghazali ◽  
Mohammed I. Malki ◽  
Mesfer Ibrahim A. Alshehri ◽  
Wafa H. Alfaifi ◽  
Afnan J. Khardali ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Literature Review ◽  
Sleep Bruxism ◽  
Clinical Risk Factor ◽  
Clinical Risk ◽  
Obstructive Sleep ◽  
Causative Link

Obstructive sleep apnea (OSA) is a clinical risk factor for sleep bruxism (SB). Although no clear causative link has been defined, both conditions are inter related to sleep-related arousal reactions [1]. A literature review was conducted on PubMed and ScienceDirect databases for 2000–2021 period. The majority of studies revealed an association between OSA and SB events.

Clinical risk factors for obstructive sleep apnea in a Korean sleep clinic

2019 ◽  
Vol 64 ◽  
pp. S175
Author(s):  
J.-Y. Jeon ◽  
H.-J. Moon ◽  
K.T. Kim ◽  
Y.W. Cho
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Obstructive Sleep

Prevalence and Risk Factors for Obstructive Sleep Apnea Syndrome Among Children and Adolescents with Cleft lip and Palate: A Survey Study in Hong Kong

2021 ◽  
pp. 105566562110683
Author(s):  
A. C. H. Ho ◽  
F. Savoldi ◽  
R. W. K. Wong ◽  
S. C. Fung ◽  
S. K. Y. Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Hong Kong ◽  
Sleep Apnea ◽  
Children And Adolescents ◽  
Cleft Lip ◽  
Sleep Apnea Syndrome ◽  
Survey Study ◽  
Obstructive Sleep ◽  
Secondary Palate

Objective To investigate the prevalence of obstructive sleep apnea syndrome (OSAS) risk and related risk factors among children and adolescents of Hong Kong with cleft lip and/or palate (CL/P). Design Retrospective survey study adopting three questionnaires, obstructive sleep apnea-18 (OSA-18), pediatric sleep questionnaire-22 (PSQ-22), and modified Epworth Sleepiness Scale (ESS). Settings Multicenter study in two public hospitals. Patients A total of 351 Chinese children and adolescents with non-syndromic CL/P (6-18-year-old, 57% males) visited between September 2017 and November 2019, with primary palatal repair surgery done before 3-year-old. Main Outcome Measure Positive OSAS risk was determined based on cut-off ≥60 for OSA-18, ≥8 for PSQ-22, and >8 for ESS. Age, sex, overweight presence, cleft type, embryonic secondary palate involvement, palatal repair surgery, palatal revision surgery, and orthodontic treatment were analyzed as possible risk factors. Results A total of 9.5% of patients had positive OSAS risk based on OSA-18, 13.6% based on PSQ-22, and 13.2% according to ESS. A higher prevalence of patients with positive OSAS risk was of younger age (OSA-18, p = .034), had cleft involving embryonic secondary palate (PSQ-22, p = .009), and history of fixed orthodontic treatment (ESS, p = .002). The regression model identified only involvement of embryonic secondary palate as a risk factor (PSQ-22, odds ratio = 3.7, p = .015). Conclusions OSAS risk among children and adolescents of Hong Kong with CL/P was 9.5% to 13.6%. Patients at higher risk were those with cleft involving embryonic secondary palate. OSAS risk assessment may be influenced by different aspects of the disease spectrum, and a multimodal approach should be considered for such assessment.

scholarly journals Evaluation of Secondary Post-Tonsillectomy Bleeding among Children in Saudi Arabia: Risk Factor Analysis

2020 ◽  
pp. 014556132094466
Author(s):  
Turki Aldrees ◽  
Abdullah Alzuwayed ◽  
Abdullah Majed ◽  
Abdulrhman Alzamil ◽  
Mohammed Almutairi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Saudi Arabia ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Sleep Disorder ◽  
Significant Risk ◽  
Peritonsillar Abscess ◽  
Recurrent Tonsillitis ◽  
Obstructive Sleep

Background: Tonsillectomy is one of the most widely recognized surgeries for tonsillitis. It is the default surgery option for obstructive sleep apnea, recurrent tonsillitis, and recurrent peritonsillar abscess. However, there are limited risk factor analyses in Saudi Arabia related to tonsillectomy. The goal of study is to evaluate and analyze the risk factors for secondary post-tonsillectomy bleeding in Saudi Arabia. Method: This retrospective review study was directed at King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia. Univariate and multivariate investigations were performed to decide the risk factors. Results: A total of 713 children were included. Post-tonsillectomy bleeding occurred in only 5.3% of tonsillectomies. There was no seasonal variation impact on post-tonsillectomy bleeding rate ( P = .8). The multivariate analysis showed a significant association between post-tonsillectomy bleeding and both age (odds ratio [OR] = 1.156; 95% CI: 1.007-1.326; P = .039) and sleep disorder breathing/obstructive sleep apnea (OR = 3.581; 95% CI: 1.454-8.820; P = .006). Conclusion: This study revealed that age, sleep disorder/obstructive sleep apnea, and longer hospital stay after tonsillectomy are significant risk factors for post-tonsillectomy bleeding. This study provides an important baseline for further local studies in the future.

scholarly journals Obstructive sleep apnea and stroke severity: Impact of clinical risk factors

2021 ◽  
Vol 7 (2) ◽  
pp. 92
Author(s):  
Thomas Nathaniel ◽  
CarolynBreauna Sanders ◽  
Krista Knisely ◽  
Camron Edrissi ◽  
Chase Rathfoot ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Clinical Risk Factors ◽  
Stroke Severity ◽  
Clinical Risk ◽  
Obstructive Sleep

scholarly journals The Prioritization of Clinical Risk Factors of Obstructive Sleep Apnea Severity Using Fuzzy Analytic Hierarchy Process

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Thaya Maranate ◽  
Adisak Pongpullponsak ◽  
Pimon Ruttanaumpawan
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Analytic Hierarchy Process ◽  
Clinical Risk Factors ◽  
Fuzzy Analytic Hierarchy Process ◽  
Analytic Hierarchy ◽  
Clinical Risk ◽  
Obstructive Sleep ◽  
Hierarchy Process

Recently, there has been a problem of shortage of sleep laboratories that can accommodate the patients in a timely manner. Delayed diagnosis and treatment may lead to worse outcomes particularly in patients with severe obstructive sleep apnea (OSA). For this reason, the prioritization in polysomnography (PSG) queueing should be endorsed based on disease severity. To date, there have been conflicting data whether clinical information can predict OSA severity. The 1,042 suspected OSA patients underwent diagnostic PSG study at Siriraj Sleep Center during 2010-2011. A total of 113 variables were obtained from sleep questionnaires and anthropometric measurements. The 19 groups of clinical risk factors consisting of 42 variables were categorized into each OSA severity. This study aimed to array these factors by employing Fuzzy Analytic Hierarchy Process approach based on normalized weight vector. The results revealed that the first rank of clinical risk factors in Severe, Moderate, Mild, and No OSA was nighttime symptoms. The overall sensitivity/specificity of the approach to these groups was 92.32%/91.76%, 89.52%/88.18%, 91.08%/84.58%, and 96.49%/81.23%, respectively. We propose that the urgent PSG appointment should include clinical risk factors of Severe OSA group. In addition, the screening for Mild from No OSA patients in sleep center setting using symptoms during sleep is also recommended (sensitivity = 87.12% and specificity = 72.22%).

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

scholarly journals Obstructive Sleep Apnea as a Risk Factor of Insulin Resistance in Nondiabetic Adults

Life ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 50
Author(s):  
Monika Michalek-Zrabkowska ◽  
Piotr Macek ◽  
Helena Martynowicz ◽  
Pawel Gac ◽  
Grzegorz Mazur ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Glucose Concentration ◽  
Insulin Concentration ◽  
Fasting Insulin ◽  
Sleep Habits ◽  
Obstructive Sleep

Objective: The aim of this research was to assess the relationship between prevalence and severity of obstructive sleep apnea (OSA) and insulin resistance among patients with increased risk of OSA without diabetes mellitus. Method and materials: our study group involved 102 individuals with suspected OSA, mean age 53.02 ± 12.37 years. Data on medical history, medication usage, sleep habits, sleep quality and daytime sleepiness, were obtained using questionnaires. All patients underwent standardized full night polysomnography. Serum fasting insulin and glucose concentration were analyzed, the homeostatic model assessment-insulin resistance (HOMA-IR) index was calculated. Results: polysomnographic study indicated that in the group with OSA mean values of apnea–hypopnea index (AHI), oxygen desaturation index (ODI), duration of SpO2 < 90% and average desaturation drop were significantly higher compared to the group without OSA, while the minimum SpO2 was significantly lower. The carbohydrate metabolism parameters did not differ within those groups. Significantly higher fasting insulin concentration and HOMA-IR index were found in the group with AHI ≥ 15 compared to the group with AHI < 15 and in the group with AHI ≥ 30 compared to the group with AHI < 30. Higher AHI and ODI were independent risk factors for higher fasting insulin concentration and higher HOMA-IR index. Increased duration of SpO2 < 90% was an independent risk factor for higher fasting glucose concentration. Conclusions: Individuals with moderate to severe OSA without diabetes mellitus had a higher prevalence of insulin resistance.

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