Montelukast for Children With Obstructive Sleep Apnea: A Double-blind, Placebo-Controlled Study

Goldbart, Aviv; Greenberg-Dotan, Sari; Tal, Asher

doi:10.1542/peds.2012-0310

Cited by 204 publications

(141 citation statements)

References 26 publications

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“…Efficacy against OSAHS has been harder to show, probably because the The importance of leukotrienes in adenoid and tonsillar inflammation was suggested by an increase in leukotriene concentration and in the number of adenoid and tonsillar leukotriene receptors in children with OSAHS compared to rates in lymphoid tissue in children with iterative pharyngitis 4 . Antileukotrienes proved effective in childhood OSAHS in a randomized double-blind placebo-controlled study of 2 groups of 23 children each 5 ; only the antileukotriene group showed radiologic regression of adenoid hypertrophy and reduced AHI.…”

Section: Pharmacologic Treatmentmentioning

confidence: 99%

Medical treatment (excluding CPAP and orthodontics) of Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)

Beydon

Aubertin

Garrec

2015

J Dentofacial Anom Orthod

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Section: Pharmacologic Treatmentmentioning

confidence: 99%

Medical treatment (excluding CPAP and orthodontics) of Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)

Beydon

Aubertin

Garrec

2015

J Dentofacial Anom Orthod

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“…While it has been suggested that such data justifies the use of intranasal steroids in otherwise healthy children with mild to moderate OSA, which subgroup of patients will benefit most, the optimal dosage, and optimal duration of therapy are still unclear. Likewise, the use of a different medication to modify leukotriene-mediated inflammation, montelukast, has also been reported to improve tissues size and respiratory indices in milder pediatric OSA in an open-label 16 week trial [43]. In a recent double-blind, placebo controlled study of montelukast in 46 children with PSG-confirmed OSA, significant improvements were reported at 12 week follow up in polysomnography (obstructive apnea index), symptoms, and adenoid size (measured by lateral neck radiograph) [44].…”

Section: Sleep Disordered Breathingmentioning

confidence: 99%

“…Central nervous system stimulants have been the drugs most widely used in the treatment of sleepiness in narcolepsy, and amphetamines were first proposed in 1935 [43]. The use of methylphenidate was later encouraged because of a shorter half-life and lower incidence of side effects.…”

Section: Narcolepsymentioning

confidence: 99%

Current Treatment of Selected Pediatric Sleep Disorders

Sullivan

2012

Neurotherapeutics

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While pediatric sleep disorders are relatively common, treatments are often not straightforward. There is often a paucity of gold standard studies and data available to guide clinicians, treatments may yield arguably incomplete results, interventions may require chronic use, and/ or involve multiple modalities including behavioral interventions that require high parental and family commitment. This review points out diagnostic differences compared to adults and focuses on current therapy for selected common pediatric sleep disorders including sleep disordered breathing/ obstructive sleep apnea, narcolepsy, and restless legs syndrome. Other common pediatric sleep disorders, such as insomnia and parasomnias, are not covered.

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“…Leukotrienes are inflammatory mediators found in the respiratory system and these play a role in several allergic childhood diseases (5). Cysteinyl leukotriene receptor-1 mediates the inflammatory pathway and has been found in high rates in postoperative adenotonsillar tissues in pediatric patients with obstructive sleep apnea (6)(7)(8).…”

mentioning

confidence: 99%

“…It is used to inhibit the inflammatory component in the disease group, which is triggered by allergic reactions (5).…”

mentioning

confidence: 99%

Evaluation of the effects of montelukast, mometasone furoate, and combined therapyon adenoid size: a randomized, prospective, clinical trial with objective data

Tuhanioğlu¹,

Erkan²

2017

Turk J Med Sci

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IntroductionAdenoids are pyramid-shaped enlarged masses of lymphoid tissue in the nasopharynx (1), and they form an important part of Waldeyer's tonsillar ring. Although the adenoids are very small at birth, they may exhibit growth in the first 4 years of life, depending on the development of the immune system (2).The incidence of adenoid hypertrophy is 2%-3% in children (2). Untreated adenoid hypertrophy may lead to difficulty in breathing through the nose, snoring, sleep apnea, nasal speech, ear problems, growth retardation, and craniofacial anomalies (1,2). Various methods are used for the diagnosis of adenoid hypertrophy including lateral head radiography, videofluoroscopy, palpation, and nasal endoscopy; the most recent methods are lateral radiographs and nasal endoscopy (3).Adenoidectomy is a commonly performed procedure in children that may cause complications such as early or late bleeding (4%-5%), adenoid tissue recurrence (10%-20%), and postoperative respiratory problems (27%) (2). In addition, anesthesia risks are also among the factors that should be taken into account (4). As such, medical therapy alternatives to adenoidectomy are important and must be tried before surgery.Leukotrienes are inflammatory mediators found in the respiratory system and these play a role in several allergic childhood diseases (5). Cysteinyl leukotriene receptor-1 mediates the inflammatory pathway and has been found in high rates in postoperative adenotonsillar tissues in pediatric patients with obstructive sleep apnea (6-8). Montelukast is an effective and reliable cysteinyl leukotriene receptor antagonist that can be used in oral form and has high bioavailability. It was approved by the United States Food and Drug Administration (FDA) for preventive therapy against the inflammatory component in asthma and allergic rhinitis in children aged over 1 year. Background/aim: The incidence of adenoid hypertrophy is 2%-3% in children. Adenoidectomy is a commonly performed procedure in children that may cause complications such as early or late bleeding (4%-5%), recurrence of adenoid tissue (10%-20%), and postoperative respiratory problems (27%). Therefore, medical therapy alternatives to adenoidectomy are important and must be tried before surgery. In this study, we investigated the efficacy of mometasone furoate, montelukast, and a combination of these drugs in pediatric patients with adenoid hypertrophy who were scheduled for reduction with medical therapy after not being recommended for surgery. Materials and methods:The study included 120 children with adenoid hypertrophy aged between 4 and 10 years. The patients were randomized into 4 separate groups, with 30 in each group. Group 1 received 100 µg of mometasone furoate per day, group 2 received 4/5 mg (for age) montelukast per day, and group 3 received mometasone furoate + montelukast. Medical therapy continued for 3 months in the treatment groups. Group 4, which comprised patients with mild symptoms, received no treatment and was the control group. The pre-and posttreatment ...

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Montelukast for Children With Obstructive Sleep Apnea: A Double-blind, Placebo-Controlled Study

Abstract: A 12-week treatment with daily, oral montelukast effectively reduced the severity of OSA and the magnitude of the underlying adenoidal hypertrophy in children with nonsevere OSA.

Cited by 204 publications

References 26 publications

Medical treatment (excluding CPAP and orthodontics) of Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)

Medical treatment (excluding CPAP and orthodontics) of Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)

Current Treatment of Selected Pediatric Sleep Disorders

Evaluation of the effects of montelukast, mometasone furoate, and combined therapyon adenoid size: a randomized, prospective, clinical trial with objective data

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