Epigenetic Alterations in Pediatric Sleep Apnea

Pediatric obstructive sleep apnea has significant negative effects on health and behavior in childhood including depression, failure to thrive, neurocognitive impairment, and behavioral issues. It is strongly associated with an increased risk for chronic adult disease such as obesity and diabetes, accelerated atherosclerosis, and endothelial dysfunction. Accumulating evidence suggests that adult-onset non-communicable diseases may originate from early life through a process by which an insult applied at a critical developmental window causes long-term effects on the structure or function of an organism. In recent years, there has been increased interest in the role of epigenetic mechanisms in the pathogenesis of adult disease susceptibility. Epigenetic mechanisms that influence adaptive variability include histone modifications, non-coding RNAs, and DNA methylation. This review will highlight what is currently known about the phenotypic associations of epigenetic modifications in pediatric obstructive sleep apnea and will emphasize the importance of epigenetic changes as both modulators of chronic disease and potential therapeutic targets.

Download Full-text

Epigenetic Alterations in Pediatric Sleep Apnea

10.20944/preprints202107.0602.v1 ◽

2021 ◽

Author(s):

Emily Catherine Cheung ◽

Matthew Wyatt Kay ◽

Kathryn Jaques Schunke

Keyword(s):

Sleep Apnea ◽

Failure To Thrive ◽

Epigenetic Mechanisms ◽

Long Term Effects ◽

Negative Effects ◽

Behavioral Issues ◽

Adult Disease ◽

Obesity And Diabetes ◽

Obstructive Sleep ◽

Increased Risk

Pediatric obstructive sleep apnea (OSA) has significant negative effects on health and behavior in childhood including depression, failure to thrive, neurocognitive impairment, and behavioral issues. It is strongly associated with an increased risk for chronic adult disease such as obesity and diabetes, accelerated atherosclerosis, and endothelial dysfunction. Accumulating evidence suggests that adult-onset non-communicable diseases may originate from early life through a process by which an insult applied at a critical developmental window causes long-term effects on the structure or function of an organism. Recently, much attention has been paid to the role of epigenetic mechanisms in the pathogenesis of adult disease susceptibility. Epigenetic mechanisms that influence adaptive variability include histone modifications, non-coding RNAs, and DNA methylation. This review will highlight what is currently known about the phenotypic associations of epigenetic modifications in pediatric OSA and will emphasize the importance of epigenetic changes as both modulators of chronic disease and potential therapeutic targets.

Download Full-text

Long-term Impact of Adenotonsillectomy on the Quality of Life of Children with Sleep-disordered breathing

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1709195 ◽

2020 ◽

Author(s):

Juliana Alves Sousa Caixeta ◽

Jessica Caixeta Silva Sampaio ◽

Vanessa Vaz Costa ◽

Isadora Milhomem Bruno da Silveira ◽

Carolina Ribeiro Fernandes de Oliveira ◽

...

Keyword(s):

Quality Of Life ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disordered Breathing ◽

Long Term Effects ◽

Obstructive Sleep ◽

Long Term Impact ◽

Disordered Breathing

Abstract Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.

Download Full-text

827 Central Sleep Apnea in a patient with Multiple Sclerosis

SLEEP ◽

10.1093/sleep/zsab072.824 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A322-A323

Author(s):

Rahul Dasgupta ◽

Sonja Schütz ◽

Tiffany Braley

Keyword(s):

Multiple Sclerosis ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disordered Breathing ◽

Central Sleep Apnea ◽

Progressive Multiple Sclerosis ◽

Obstructive Sleep ◽

Increased Risk ◽

Demyelinating Lesions ◽

The Brain

Abstract Introduction Sleep-disordered breathing is common in persons with multiple sclerosis (PwMS), and may contribute to debilitating fatigue and other chronic MS symptoms. The majority of research to date on SDB in MS has focused on the prevalence and consequences of obstructive sleep apnea; however, PwMS may also be at increased risk for central sleep apnea (CSA), and the utility of methods to assess CSA in PwMS warrant further exploration. We present a patient with secondary progressive multiple sclerosis who was found to have severe central sleep apnea on WatchPAT testing. Report of case(s) A 61 year-old female with a past medical history of secondary progressive multiple sclerosis presented with complaints of fragmented sleep. MRI of the brain, cervical spine, and thoracic spine showed numerous demyelinating lesions in the brain, brainstem, cervical, and thoracic spinal cord. Upon presentation, the patient noted snoring, witnessed apneas, and daytime sleepiness. WatchPAT demonstrated severe sleep apnea, with a pAHI of 63.3, and a minimum oxygen saturation of 90%. The majority of the scored events were non-obstructive in nature (73.1% of all scored events), and occurred intermittently in a periodic fashion. Conclusion The differential diagnosis of fatigue in PwMS should include sleep-disordered breathing, including both obstructive and central forms of sleep apnea. Demyelinating lesions in the brainstem (which may contribute to impairment of motor and sensory networks that control airway patency and respiratory drive), and progressive forms of MS, have been linked to both OSA and CSA. The present data illustrate this relationship in a person with progressive MS, and offer support for the WatchPAT as a cost-effective means to evaluate for both OSA and CSA in PwMS, while reducing patient burden. PwMS may be at increased risk for CSA. Careful clinical consideration should be given to ordering appropriate sleep testing to differentiate central from obstructive sleep apnea in PwMS, particularly for patients with demyelinating lesions in the brainstem. Support (if any) 1. Braley TJ, Segal BM, Chervin RD. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. J Clin Sleep Med. 2014 Feb 15;10(2):155–62. doi: 10.5664/jcsm.3442. PMID: 24532998; PMCID: PMC3899317.

Download Full-text

Increased Risk of Parkinsonʼs Disease in Patients With Obstructive Sleep Apnea

Medicine ◽

10.1097/md.0000000000002293 ◽

2016 ◽

Vol 95 (2) ◽

pp. e2293 ◽

Cited By ~ 31

Author(s):

Nai-Cheng Yeh ◽

Kai-Jen Tien ◽

Chun-Ming Yang ◽

Jhi-Joung Wang ◽

Shih-Feng Weng

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep ◽

Increased Risk

Download Full-text

The long-term effects of mandibular advancement splint on cardiovascular fitness and psychomotor performance in patients with mild to moderate obstructive sleep apnea: a prospective study

Sleep And Breathing ◽

10.1007/s11325-017-1534-1 ◽

2017 ◽

Vol 21 (3) ◽

pp. 781-789 ◽

Cited By ~ 2

Author(s):

Ashutosh Gupta ◽

Arvind Tripathi ◽

Piyush Sharma

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Prospective Study ◽

Cardiovascular Fitness ◽

Mandibular Advancement ◽

Long Term Effects ◽

Mandibular Advancement Splint ◽

Obstructive Sleep ◽

A Prospective Study

Download Full-text

Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores

Life ◽

10.3390/life11050368 ◽

2021 ◽

Vol 11 (5) ◽

pp. 368

Author(s):

Leeba Rezaie ◽

Soroush Maazinezhad ◽

Donald J. Fogelberg ◽

Habibolah Khazaie ◽

Dena Sadeghi-Bahmani ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Multiple Regression ◽

Daytime Sleepiness ◽

Respiratory Disturbance Index ◽

Disturbance Index ◽

Related Data ◽

Obstructive Sleep ◽

Increased Risk ◽

Respiratory Disturbance

Objective: Individuals with obstructive sleep apnea (OSA) are at increased risk to suffer from further somatic and sleep-related complaints. To assess OSA, demographic, anthropometric, and subjective/objective sleep parameters are taken into consideration, but often separately. Here, we entered demographic, anthropometric, subjective, and objective sleep- and breathing-related dimensions in one model. Methods: We reviewed the demographic, anthropometric, subjective and objective sleep- and breathing-related data, and polysomnographic records of 251 individuals with diagnosed OSA. OSA was considered as a continuous and as categorical variable (mild, moderate, and severe OSA). A series of correlational computations, X2-tests, F-tests, and a multiple regression model were performed to investigate which demographic, anthropometric, and subjective and objective sleep dimensions were associated with and predicted dimensions of OSA. Results: Higher apnea/hypopnea index (AHI) scores were associated with higher BMI, higher daytime sleepiness, a higher respiratory disturbance index, and higher snoring. Compared to individuals with mild to moderate OSA, individuals with severe OSA had a higher BMI, a higher respiratory disturbance index (RDI) and a higher snoring index, while subjective sleep quality and daytime sleepiness did not differ. Results from the multiple regression analysis showed that an objectively shorter sleep duration, more N2 sleep, and a higher RDI predicted AHI scores. Conclusion: The pattern of results suggests that blending demographic, anthropometric, and subjective/objective sleep- and breathing-related data enabled more effective discrimination of individuals at higher risk for OSA. The results are of practical and clinical importance: demographic, anthropometric, and breathing-related issues derived from self-rating scales provide a quick and reliable identification of individuals at risk of OSA; objective assessments provide further certainty and reliability.

Download Full-text

Abstract P068: Obstructive Sleep Apnea is Associated with an Increase Risk of Osteoporosis

Circulation ◽

10.1161/circ.131.suppl_1.p068 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Anawin Sanguankeo ◽

Sikarin Upala

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Primary Outcome ◽

Meta Analysis ◽

Systemic Disease ◽

Obstructive Sleep ◽

Increased Risk ◽

Increase Risk ◽

Osteoporosis Risk ◽

Stimulation Of

Background: Obstructive sleep apnea (OSA) is thought to be a systemic disease and has been associated with many disorders such as metabolic, endocrine, and especially cardiovascular diseases. One of the consequences of OSA is hypoxia, which can lead to a reduction in growth of osteoblast and a stimulation of osteoclast. Our meta-analysis was conducted to determine the risk of osteoporosis in patients with OSA compared to controls. Objectives: Eligible studies assessing the effects of obstructive sleep apnea on osteoporosis risk were comprehensively searched in PubMed/MEDLINE, EMBASE, and CENTRAL from their inception to September 2014. Two authors independently assessed article quality and extracted the data. Primary outcome were number of participants, prevalence, or risk ratio of osteoporosis in OSA and controls. Results: From 40 full-text articles, 3 studies involving 113,090 participants were included in the meta-analysis that were based on the random effects model. Compared with controls, participants who were diagnosed with obstructive sleep apnea had increased risk of osteoporosis (pooled risks ratio, 1.85; 95% CI, 1.34, 2.56). Conclusion: Patients with OSA had a higher risk of developing osteoporosis. Further study is needed to evaluate the possible mechanisms between these two conditions and to find potential treatment for OSA that could prevent osteoporosis.

Download Full-text