Obstructive sleep apnoea presenting as failure to thrive in infancy

Freezer, Nicholas; Bucens, Ingrid K; Robertson, Colin F.

doi:10.1111/j.1440-1754.1995.tb00779.x

Cited by 106 publications

(54 citation statements)

References 13 publications

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“…Indeed, failure to thrive (FTT) used to be one of the common sequelae of childhood OSA [133][134][135]. However, the frequency of this problem has markedly diminished in recent years.…”

Section: Somatic Growth Impairmentmentioning

confidence: 99%

Childhood Obstructive Sleep Apnea: One or Two Distinct Disease Entities?

Dayyat

Kheirandish‐Gozal

Gozal

2007

Sleep Medicine Clinics

210

114

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The spectrum of sleep disordered breathing (SDB) encompasses habitual snoring at the low end of severity all the way to frank obstructive sleep apnea (OSA), with upper airway resistance syndrome (UARS) and obstructive alveolar hypoventilation being considered as less severe variants of this condition. SDB occurs in children of all ages, from neonates to adolescents, and is characterized by repeated events of increased upper airway resistance as well as with either partial or complete upper airway obstruction during sleep, all of which may result in disruption of normal gas exchange and sleep integrity [1]. SDB was initially described over a century ago [2] and was then rediscovered in children by Guilleminault in 1976 [3]. However, this complex and relatively prevalent disorder is only now being recognized as a major public health problem. During the initial years since the seminal paper by Guilleminault et al [3], it became apparent that the classic clinical syndrome of OSA in children markedly differed from the OSA seen in adults, in particular with respect to gender distribution, clinical manifestations, polysomnographic findings, and treatment approaches [4,5]. However in more recent years, the epidemic of obesity that affects the pediatric population all over the world has led, in our opinion, to the emergence of a phenotypic variant of OSA in children that closely resembles that of adults with the disease. In this paper, we will review the pathophysiological mechanisms of OSA in children, delineate the clinical manifestations associated with the disease, and provide arguments for our novel and hopefully useful proposition that aims to define 2 types of OSA in children. For the sake of convenience, and in analogy with type I and type II diabetes, we propose to divide pediatric OSA as types I and II. Keywordsobstructive sleep apnea; adenotonsillar hypertrophy; obesity; inflammation; upper airway; snoring Epidemiology of Pediatric OSAHabitual snoring during sleep, the hallmark indicator of increased upper airway resistance, is an extremely frequent occurrence during childhood, with up to 27% of children being affected [6][7][8][9][10][11][12][13][14]. SDB is most common in young children (pre-school and early school years), with a peak prevalence around 2-8 years, and subsequent declines in frequency [15]. However, accurate prevalence information is missing, particularly in infants, since most epidemiological studies have to date concentrated on older children. Furthermore, the exact polygraphic Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. demarcation betwee...

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“…Indeed, failure to thrive (FTT) used to be one of the common sequelae of childhood OSA [133][134][135]. However, the frequency of this problem has markedly diminished in recent years.…”

Section: Somatic Growth Impairmentmentioning

confidence: 99%

Childhood Obstructive Sleep Apnea: One or Two Distinct Disease Entities?

Dayyat

Kheirandish‐Gozal

Gozal

2007

Sleep Medicine Clinics

210

114

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“…[1][2][3] Significant complications of untreated OSA include learning difficulties. [4][5][6][7] behavioral problems, 8,9 failure to thrive, 10,11 pulmonary hypertension [12][13][14][15] and systemic hypertension. 16,17 Early diagnosis can decrease morbidity, 16 however the diagnosis of OSA is often delayed by months to years because of inadequate screening.…”

Section: Introductionmentioning

confidence: 99%

Inter‐ and intra‐rater reliability of neck circumference measurements in children

LaBerge

Vaccani

Gow

et al. 2008

Pediatric Pulmonology

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Summary. Rationale: Increased neck circumference is a risk factor for obstructive sleep apnea in adults. With rising obesity prevalence in children, it may be an important identifier of obstructive sleep apnea in children. The reliability of measuring neck circumference in children has not been systematically evaluated. Objective: To determine the inter-and intra-rater reliability of neck circumference measurements in children aged 2-16 years. Methods: Children aged 2-16 years with limb fractures were recruited. Neck circumference was measured by three investigators each using two separate unmarked paper tapes in the 2-5 year age group (N ¼ 43), and three separate tapes in the 6-10 and 11-16 year age groups (N ¼ 18 and 40). Results: Neck circumference measurements showed excellent inter-rater reliability for children 6-10 and 11-16 years (ICC ¼ 0.952 and 0.989). Substantial variation was observed for the 2-5 year age group (ICC ¼ 0.701). Good intra-rater reliability was demonstrated for the three groups (ICC range: 0.776, 0.950). Repeatability coefficients were 2.5-3.4 cm in the youngest age group and were 1.2-1.4 cm in the 6-16 year age group. Conclusion: In children 6-16 years old, neck circumference shows very good inter and good intra-rater reliability. Multiple measurements are not required for precision and reliability.

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“…Obesity, a typical feature of adults with OSA, is uncommon in children [31] but, if observed, may be associated with reduced daytime activity [1,34,35]. More typically these children have poor weight gain and small stature [37]. In contrast with OSA in adults where daytime somnolence and poor concentration are characteristic features, these are not typical presenting complaints in children and, in fact, hyperactivity is common [31].…”

Section: Clinical Featuresmentioning

confidence: 99%

Obstructive sleep apnoea syndrome in children

Warwick

Mason

1998

Anaesthesia

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SummaryObstructive sleep apnoea syndrome in children is a complex disorder characterised by repeated nocturnal episodes of increased upper airway resistive load. It is most commonly associated with adenotonsillar hypertrophy and more children are now presenting for adenotonsillectomy. These children may pose different anaesthetic problems to those having surgery for recurrent infection alone and anaesthetic morbidity and mortality has been reported. In addition, due to the varied symptomatology of the condition, children with unrecognised obstructive sleep apnoea syndrome may present for incidental surgery. This is of importance as patients with undiagnosed obstructive sleep apnoea syndrome may experience additional peri-operative morbidity when undergoing incidental surgery. This article aims to review the aetiology, pathophysiology, clinical presentation and anaesthetic management of children with obstructive sleep apnoea syndrome.

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Obstructive sleep apnoea presenting as failure to thrive in infancy

Cited by 106 publications

References 13 publications

Childhood Obstructive Sleep Apnea: One or Two Distinct Disease Entities?

Childhood Obstructive Sleep Apnea: One or Two Distinct Disease Entities?

Inter‐ and intra‐rater reliability of neck circumference measurements in children

Obstructive sleep apnoea syndrome in children

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