scholarly journals Obstructive Apnea and Hypopnea Length in Normal Children and Adolescents

2021 ◽  
Vol 11 (10) ◽  
pp. 1343
Author(s):  
Lourdes M. DelRosso ◽  
David Panek ◽  
Greg Redding ◽  
Maria Paola Mogavero ◽  
Chris Ruth ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Behavioral Control ◽  
Respiratory Muscles ◽  
Exclusion Criteria ◽  
Normal Children ◽  
Sleep Studies ◽  
Apnea Duration ◽  
Essential Function

(1) Background: Breathing is an essential function that requires both metabolic (or au-tomatic) and voluntary (behavioral) control during wakefulness but during sleep depends on metabolic control via peripheral and central chemoreceptors. Breathing during sleep disordered breathing also depends on the maturity of the neural centers and the strength of the respiratory muscles. We do not know if the response to apnea varies with age. (2) Methods: We measured the obstructive apneas and hypopneas during REM and NREM in polysomnography studies from children referred for snoring. Exclusion criteria: younger than 1 year of age, neuromuscular or syndrome comorbidity, oxygen or positive airway pressure, central apnea, and studies with loss of airflow sensors. (3) Results: Two-hundred-and-sixty-eight sleep studies were included. Mean age was 8.7 years (4.68 SD), range 1–18 years, 160 were male, and 108 were female. The 5th centile of apnea duration during NREM is above 8 s at all ages, with a tendency to increase in the oldest groups up to 10 s. During REM sleep, it shows a gradual increase from 6 s in the youngest children to 10 s in the oldest. (4) Conclusions: Apnea/hypopnea length increases with age in children and adolescents independently from sex or severity of OSA. Using adult criteria in teens seems to be accurate.

scholarly journals Sleep Disordered Breathing in Children

2016 ◽  
Vol 02 (02) ◽  
pp. 52
Author(s):  
Refika Ersu ◽  
Keyword(s):  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Residual Disease ◽  
Sleep Apnoea ◽  
Diagnosis And Treatment ◽  
Sleep Studies ◽  
Home Based ◽  
Obstructive Sleep ◽  
Overnight Oximetry ◽  
Predict Treatment Response

Although obstructive sleep apnoea (OSA) is a common problem in childhood, there are still unanswered questions regarding diagnosis and treatment. Polysomnography is the gold standard in diagnosing and assessing the severity of OSA. However, it is not always accessible and may not correlate with morbidity or predict treatment response. Home-based sleep studies and overnight oximetry are alternative diagnostic options. Adenotonsillectomy is the main treatment modality but residual disease is common. Continuous positive airway pressure is a treatment option in children who are not surgical candidates or have residual disease, but adherence is a significant issue. An individualised approach to diagnosis and treatment may improve both diagnosis and treatment in children with OSA, and prevent morbidity.

scholarly journals Sleep Laboratories Reopening and COVID-19: A European Perspective

2020 ◽  
pp. 2002722
Author(s):  
Sophia Schiza ◽  
Anita Simonds ◽  
Winfried Randerath ◽  
Francesco Fanfulla ◽  
Dries Testelmans ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Management Strategies ◽  
Sleep Medicine ◽  
European Respiratory Society ◽  
Optimal Care ◽  
Sleep Studies ◽  
Consensus Document ◽  
Sleep Laboratories ◽  
Near Future

The clinical activities regarding sleep disordered breathing (SDB) have been sharply interrupted during the initial phase of the COVID-19 epidemic throughout Europe. In the last months, activities have gradually restarted, according to epidemiological phase of COVID-19 and National recommendations. The recent increase in cases throughout Europe obliges to reconsider management strategies of SDB accordingly. Diagnosis of SDB and initiation of treatment pose some specific problems to be addressed to preserve safety of the patients and health personnel. This perspective document by a group of European sleep experts aims at summarising some different approaches followed in Europe and United States, which reflect National recommendations according to the epidemiological phase of the COVID-19 infection. Respiratory sleep medicine will likely change in the near future, and use of telemedicine will grow to avoid unnecessary risks and continue to provide optimal care to the patients. The document also covers pediatric sleep studies and indications for titration of noninvasive ventilation, as well as precautions to be followed by patients who are already on positive airway pressure treatment. A single consensus document developed by the European Respiratory Society and National Societies would be desirable to harmonise SDB management throughout Europe.

Sleep-disordered breathing

2019 ◽  
pp. 307-317
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Sleep Studies ◽  
Mallampati Score ◽  
Sleep Physiology ◽  
Disordered Breathing

This chapter reviews sleep physiology in relation to sleep-disordered breathing spectrum. The assessment of a patient with sleep-disordered breathing from examination, the role of the Epworth Sleepiness Score, sleep studies, and their interpretation are outlined. Treatments, including continuous positive airway pressure (CPAP), appliances, and surgery are discussed. Success based upon the Mallampati score and the Friedman classification are described.

scholarly journals Apnoea–hypopnoea indices determined via continuous positive airway pressure (AHI-CPAPflow) versus those determined by polysomnography (AHI-PSGgold): a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044499
Author(s):  
Fanny Bertelli ◽  
Carey Meredith Suehs ◽  
Jean Pierre Mallet ◽  
Marie Caroline Rotty ◽  
Jean Louis Pepin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
The Impact ◽  
Disordered Breathing

Introduction To date, continuous positive airway pressure (CPAP) remains the cornerstone of obstructive sleep apnoea treatment. CPAP data describing residual sleep-disordered breathing events (ie, the CPAP-measured apnoea–hypopnoea indices (AHI-CPAPflow)) is difficult to interpret because it is an entirely different metric than the polysomnography (PSG) measured AHI gold standard (AHI-PSGgold). Moreover, manufacturer definitions for apnoea and hypopnoea are not only different from those recommended for PSG scoring, but also different between manufacturers. In the context of CPAP initiation and widespread telemedicine at home to facilitate sleep apnoea care, there is a need for concrete evidence that AHI-CPAPflow can be used as a surrogate for AHI-PSGgold. Methods and analysis No published systematic review and meta-analysis (SRMA) has compared the accuracy of AHI-CPAPflow against AHI-PSGgold and the primary objective of this study is therefore to do so using published data. The secondary objectives are to similarly evaluate other sleep disordered breathing indices and to perform subgroup analyses focusing on the inclusion/exclusion of central apnoea patients, body mass index levels, CPAP device brands, pressure titration modes, use of a predetermined and fixed pressure level or not, and the impact of a 4% PSG desaturation criteria versus 3% PSG on accuracy. The Preferred Reporting Items for SRMA protocols statement guided study design. Randomised controlled trials and observational studies of adult patients (≥18 years old) treated by a CPAP device will be included. The CPAP intervention and PSG comparator must be performed synchronously. PSGs must be scored manually and follow the American Academy of Sleep Medicine guidelines (2007 AASM criteria or more recent). To assess the risk of bias in each study, the Quality Assessment of Diagnostic Accuracy Studies 2 tool will be used. Ethics and dissemination This protocol received ethics committee approval on 16 July 2020 (IRB_MTP_2020_07_2020000404) and results will be disseminated via peer-reviewed publications. PROSPERO/Trial registration numbers CRD42020159914/NCT04526366; Pre-results

scholarly journals Sleep Disordered Breathing in Children and Adolescents with Chiari Malformation Type I

2013 ◽  
Vol 09 (04) ◽  
pp. 371-377 ◽  
Author(s):  
Anna Losurdo ◽  
Serena Dittoni ◽  
Elisa Testani ◽  
Chiara Di Blasi ◽  
Emanuele Scarano ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Chiari Malformation ◽  
Sleep Disordered Breathing ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Disordered Breathing

Urinary Hydroxyproline Excretion in Normal Children and Adolescents.

1964 ◽  
Vol 115 (1) ◽  
pp. 85-87 ◽  
Author(s):  
C. R. Jones ◽  
M. W. Bergman ◽  
P. J. Kittner ◽  
W. W. Pigman
Keyword(s):  
Children And Adolescents ◽  
Urinary Hydroxyproline ◽  
Normal Children ◽  
Hydroxyproline Excretion

Association between sleep disordered breathing in early pregnancy and glucose metabolism

SLEEP ◽  
2022 ◽  
Author(s):  
Laura Sanapo ◽  
Margaret H Bublitz ◽  
Alice Bai ◽  
Niharika Mehta ◽  
Geralyn M Messerlian ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Glucose Metabolism ◽  
Early Pregnancy ◽  
Airway Pressure ◽  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Obstructive Sleep ◽  
Respiratory Event

Abstract Study Objectives To examine the association between maternal sleep disordered breathing (SDB) and glucose metabolism in early gestation. Methods Women with body mass index (BMI) ≥27 kg/m2 and singleton pregnancies underwent in-home sleep study (HSAT) and homeostatic model assessment (HOMA) in early pregnancy. Insulin resistance (HOMA-IR) and β-cell function (HOMA %B) were derived. Exclusion criteria included pregestational diabetes, use of continuous positive airway pressure and chronic steroid therapy. We performed linear regression analyses to evaluate the association between continuous measures of SDB (respiratory event index (REI), and oxygen desaturation index (ODI)) and glucose metabolism parameters (HOMA-IR and HOMA %B). Analyses were adjusted for a set of a priori selected variables which included gestational age, maternal age, BMI, ethnicity, race, and parity. Results One hundred and ninety-two pregnant women with median (interquartile range) BMI of 35.14 (8.30) kg/m2 underwent HSAT and HOMA assessment at 11.14 (3) and 15.35 (4.14) gestational weeks, respectively. REI and ODI, as continuous values, were associated with HOMA-IR after adjusting for covariates. OSA (obstructive sleep apnea) diagnosis (REI > 5 events per hour) was not associated with HOMA-IR after adjusting for BMI (p ≥ 0.05). None of the parameters were associated with HOMA %B (p > 0.07). Conclusions SDB and insulin resistance are associated in early pregnancy, with a dose response association between respiratory event index severity and insulin resistance. Further studies are needed to establish if pregnant women with overweight and obesity may benefit from early SDB screening to improve glucose metabolic outcome. Clinical trials: NCT02412696, Positive Airway Pressure, Sleep Apnea, and the Placenta (PAP-SAP) https://clinicaltrials.gov/ct2/show/NCT02412696?term=Bourjeily&draw=2&rank=2 and NCT02917876, Predictors of De-novo Development of Obstructive Sleep Apnea in Pregnancy (Predictors) https://clinicaltrials.gov/ct2/show/NCT02917876?term=Bourjeily&draw=2&rank=1

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