Polysomnographic and Clinical Findings in Children With Obstructive Sleep Apnea

Leach, Joseph L.; Olson, Jerold; Hermann, John S.; Manning, Scott C.

doi:10.1001/archotol.1992.01880070071013

Cited by 169 publications

(111 citation statements)

References 17 publications

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“…The children in this study had all symptoms suggestive of OSAS, although the majority were found to be PSs. This is consistent with the findings from other studies, 40,41 where half or less of the children with such symptoms were actually confirmed to have OSAS. The criterion for OSAS, OAHI of 1 or higher, was based on normative data established by others 18 and our own findings in a group of 30 normal children.…”

Section: Discussionsupporting

confidence: 93%

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

et al. 2002

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ABSTRACT. Objective. The pathophysiological mechanisms of growth impairment frequently associated with the obstructive sleep apnea syndrome (OSAS) in children are poorly defined. The main objective of this study was to evaluate whether nighttime upper airway obstruction attributable to adenotonsillar hypertrophy and subsequent surgical treatment affect the circulating concentrations of insulin-like growth factor-I (IGF-I) and IGFbinding protein 3 (IGFBP-3) along with other growth parameters in children.Patients and Methods. We initially studied 70 children (mean age: 5.8 years; range: 2.4 -10.5 years) admitted to a university hospital because of clinical symptoms of OSAS. Their sleep was monitored with a 6-channel computerized polygraph. Data on anthropometry and circulating concentrations of IGF-I and IGFBP-3 were generated and compared with corresponding characteristics in control children (N ‫؍‬ 35). Thirty children with an obstructive apnea-hypopnea index (OAHI) of 1 or more were categorized as children with OSAS (mean OAHI: 5.4 [95% confidence interval for mean (CI): 3.8 -6.9]), whereas 40 children with an OAHI of <1 were considered as primary snorers (PS) (mean OAHI 0.13 [95% CI: 0.05-0.21]). Nineteen children with OAHI >2 underwent adenotonsillectomy attributable to OSAS and were reassessed 6 months later together with 34 nonoperated children with OAHI <2.Results. There were no initial differences in relative height and weight for height between the 3 groups of children. No differences were observed in peripheral IGF-I concentrations, but both OSAS and PS children had reduced peripheral IGFBP-3 levels. The operated children with initial OSAS experienced a highly significant reduction in their OAHI from 7.1 (95% CI: 5.1-9.1) to 0.37 (95% CI: 0.2-0.95). Weight-for-height, body mass index, body fat mass, and fat-free mass increased during the follow-up in the operated children with OSAS, whereas only fat-free mass and relative height increased in the PS children. Both the IGF-I and the IGFBP-3 concentrations increased significantly in the operated children, whereas no significant changes were seen in the PS children.Conclusions. These observations indicate that growth hormone secretion is impaired in children with OSAS and PS. Respiratory improvement after adenotonsillectomy in children with OSAS results in weight gain and restored growth hormone secretion. Pediatrics 2002;109(4). URL: http://www.pediatrics.org/cgi/content/full/109/4/e55; snoring, obstructive sleep apnea, growth hormone, insulinlike growth factor-I, insulin-like growth factor-binding protein 3.ABBREVIATIONS. OSAS, obstructive sleep apnea syndrome; GH, growth hormone; IGF-I, insulin-like growth factor-I; IGFBP-3, insulin-like growth factor-binding protein 3; PS, primary snorer; EMG, electromyogram; OAHI, obstructive sleep apnea-hypopnea index; SDS, standard deviation score; BMI, body mass index; SWS, slow-wave sleep. S noring is relatively common in children, with the prevalence of regular snoring about 10% in preschool-aged subjects. 1-3 Obs...

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Section: Discussionsupporting

confidence: 93%

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

et al. 2002

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“…Current knowledge shows that this group of diseases have negative effects on children in whom an early diagnosis is not made, [3][4][5][6][7][8] causing major loss of quality of life for the patients and concerns for their caretakers.…”

Section: Resultsmentioning

confidence: 99%

“…It is estimated that up to 3% of children have OSAHS, 1 and that a higher percentage has UARS. 2 OSDs cause a variety of physical conditions and affect the child's quality of life, leading to low weight gain, altered cranio-facial development, [3][4][5] cardiopulmonary sequelae, 3,4 behavioral changes, 3,4,6,7 and poor school performance, 8 all of which have been well documented. Thus an early diagnosis and treatment of OSDs in pediatric patients is paramount to revert or avoid these conditions.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14][15] Thus adenoidectomy or adenotonsillectomy are the procedures of choice for treating OSDs in the pediatric population; these procedures effectively control nocturnal symptoms, relieving physical repercussions and normalizing the polysomnographic test. [16][17][18][19] Although the objective improvement of this condition has been well documented, there have been few reports about subjective improvements in the quality of life of children and the degree of satisfaction of their parents following adenotonsillectomy; the subjective improvement remains presumed.…”

Section: Introductionmentioning

confidence: 99%

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Resultados na qualidade de vida em longo prazo de crianças submetidas à adenoidectomia/adenotonsilectomia por distúrbios obstrutivos do sono

Júnior

Silva

Freitas

2008

Rev. Bras. Otorrinolaringol.

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Obst ructive Sleep Disorders (OSD) affect mostly the pediatric population. Within this group, its main etiology is adenotonsillar hyperplasia, being adenoidectomy or adenotonsillectomy the best treatment option for quality of life improvement. Aim: To asses quality of life of children with OSD after adenoidectomy/adenotonsillectomy. Method: A prospective study was carried out with 48 children, between 2 and 11 years, with clinical manifestations of OSD and obstructive adenotonsillar hyperplasia. The OSA18 questionnaire was answered by the parents to evaluate their children's quality of life before surgery; at about thirty days and at least eleven months after the procedure. A higher score meant a worse quality of life. Results: Before surgery, the average OSA18 score was 82.83(SD=12.57), with an average global score for quality of life of 6.04(SD=1.66). Within thirty days after surgery, the average OSA18 score was 34.3 (SD=9.95) with an average global score of 9.6(SD=0.81), both showing significant reduction (p< 0.001). Thirty-four children (70.83%) were re-evaluated between 11 and 30 months (average=16.85; SD=5.16). The average OSA18 score was 35.44 (SD=19.95) with an average global score of 9.28 (SD=1.78). The postoperative evaluations weren't significantly different. Conclusion: surgery improves the quality of life of children with OSD, and such improvement maintains for the long run.

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“…Other investigators have concluded that parents and physicians may overestimate the severity of the sleep disturbances and have recommended other ancillary testing to confirm the diagnosis. 66 Soft tissue lateral x-ray films are most commonly used to assess adenoid hypertrophy. However, it is important to realize that these are two-dimensional studies and their accuracy in assessing the degree of nasal obstruction because of adenoid hypertrophy is controversial.…”

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confidence: 99%

Obstructive Sleep Apnea: Part I. Diagnosis and Evaluation.

Babu¹,

PC²,

Reddy³

et al. 2017

IJAR

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Obstructive sleep apnea (OSA) is a common disorder that is characterized by repetitive partial or complete cessation of airflow, associated with oxyhemoglobin desaturation and increased effort to breath. Patients with undiagnosed sleep apnea represent a major public health problem. Dental professionals have a unique doctor patient relationship that can help them in recognizing the sleep disorder and co-managing the patients along with a physician or a sleep-specialist. This article discusses the etiology and pathogenesis, clinical features and risk factors, consequences, diagnosis and evaluation of Obstructive sleep apnea.

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Polysomnographic and Clinical Findings in Children With Obstructive Sleep Apnea

Cited by 169 publications

References 17 publications

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

Resultados na qualidade de vida em longo prazo de crianças submetidas à adenoidectomia/adenotonsilectomia por distúrbios obstrutivos do sono

Obstructive Sleep Apnea: Part I. Diagnosis and Evaluation.

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