Obstructive sleep disorders in Prader–Willi syndrome: The role of surgery and growth hormone

Effect of Obesity and Medical Comorbidities on Outcomes After Adjunct Surgery for Obstructive Sleep Apnea in Cases of Adenotonsillectomy Failure

“…Finally, although the presence of medical comorbidities pertaining to generalized hypotonia and neuromuscular dysfunction was identified in each case by thorough multidisciplinary evaluation, the specific relationship of the comorbid conditions to OSAS in general, and to the specific anatomic abnormalities addressed surgically, was not fully developed. Although evidence has been presented that particular conditions-including Down syndrome, Prader-Willi syndrome, and cerebral palsy, all of which were represented in this study-put children at higher risk for obstructive sleep apnea, 3,4,17 the specific pathophysiologic mechanisms have not yet been identified, nor have improved methods of addressing it beyond standard interventions.…”

Drug-induced sleep endoscopy in children with Prader-Willi syndrome

“…However, recent studies found that children with PWS who demonstrate severe OSA may not experience complete resolution of sleep apnea after adenotonsillectomy [7,[10][11][12][13]. It is also known that results of adenotonsillectomy in certain patient populations, including obese individuals and those with specific comorbidities, such as trisomy 21 (Down) syndrome, cerebral palsy, and craniofacial abnormalities, are suboptimal than in children without these comorbidities [20][21][22].…”

“…However, there is some controversy as to whether GH treatment exacerbates or ameliorates OSA. Therefore, children should be monitored carefully for the symptoms of OSA throughout GH treatment, and PSG should be followed [3,[6][7][8].…”

“…Although adenotonsillectomy is generally effective in most children with PWS, it may not be curative in children with severe OSA [7,[10][11][12][13]. An increase in central apneas has been reported in some children postoperatively [11].…”

Síndrome de la apnea-hipoapnea obstructiva del sueño en el niño: más allá de la hipertrofia adenoamigdalar

“…Sin embargo esta terapia, especialmente en los primeros meses de tratamiento, se ha asociado con muerte súbita, quizás por un incremento del SAHOS 27,85,111,112 .…”