Polysomnographic Characteristics in Normal Preschool and Early School-Aged Children

Montgomery‐Downs, Hawley E.; O’Brien, Louise M.; Gulliver, Tanya; Gozal, David

doi:10.1542/peds.2005-1067

Cited by 448 publications

(359 citation statements)

References 46 publications

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“…The obstructive sleep apnea syndrome was defined as an obstructive apnea-hypopnea index (AHI) score of 2 or more events per hour or an obstructive apnea index (OAI) score of 1 or more events per hour. [7][8][9][10] Children with an AHI score of more than 30 events per hour, an OAI score of more than 20 events per hour, or arterial oxyhemoglobin saturation of less than 90% for 2% or more of the total sleep time were not eligible, owing to the severity of the polysomnographic findings. Exclusion criteria included recurrent tonsillitis, a z score based on the body-mass index (the weight in kilograms divided by the square of the height in meters) of 3 or more, and medication for attention deficithyperactivity disorder (ADHD).…”

Section: Methods Study Design and Patientsmentioning

confidence: 99%

“…However, no changes were observed in stage N3 or in rapid-eye-movement sleep. Normalization of the obstructive sleep apnea syndrome, as defined by a reduction in both the AHI score to fewer than two events per hour and the OAI score to fewer than one event per hour, [7][8][9][10] was more common in the early-adenotonsillectomy group than in the watchful-waiting group (79% vs. 46%, P<0.001).…”

Section: Study Outcomesmentioning

confidence: 97%

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A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea

Marcus

Moore

Rosen

et al. 2014

Survey of Anesthesiology

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229

438

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BACKGROUND-Adenotonsillectomy is commonly performed in children with the obstructive sleep apnea syndrome, yet its usefulness in reducing symptoms and improving cognition, behavior, quality of life, and polysomnographic findings has not been rigorously evaluated. We hypothesized that, in children with the obstructive sleep apnea syndrome without prolonged oxyhemoglobin desaturation, early adenotonsillectomy, as compared with watchful waiting with supportive care, would result in improved outcomes.

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Section: Methods Study Design and Patientsmentioning

confidence: 99%

Section: Study Outcomesmentioning

confidence: 97%

A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea

Marcus

Moore

Rosen

et al. 2014

Survey of Anesthesiology

Self Cite

229

438

View full text Add to dashboard Cite

show abstract

“…However, the characteristics of sleep patterns and the architecture of sleep vary dramatically throughout development. Between 3 and 5 y of age, total sleep time and time in "deep" sleep stages, slow-wave sleep (SWS) and rapid eye movement sleep (REM), decline significantly (10,11). Moreover, in early childhood, sleep bouts are distributed across the day.…”

mentioning

confidence: 99%

Sleep spindles in midday naps enhance learning in preschool children

Kurdziel¹,

Duclos

Spencer³

2013

Proc. Natl. Acad. Sci. U.S.A.

214

253

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“…In addition to obstructive respiratory events, adults, children, and neonates can exhibit central apneas during sleep, where there is no, or reduced, brain stem motor output. Central apneas have been described in healthy children during sleep and are known to decrease with age (12,13). A similar cardiovascular response is also associated with central apneas in children with SDB (14).…”

mentioning

confidence: 86%

Augmented cardiovascular responses to episodes of repetitive compared with isolated respiratory events in preschool children with sleep-disordered breathing

et al. 2015

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Data presented as mean ± SEM or median (range). *P < 0.05; † P < 0.001. HR, heart rate; PTT, pulse transit time. Articles Walter et al. Cardiovascular Consequences of Repetitive vs. Isolated Respiratory EventsFor the episodes of repetitive events, the % change in HR from late to between events and from late event to postepisode were significantly higher when compared with the % change in HR from late to postevent in isolated respiratory events (P < 0.001 for both), as shown in Figure 2a. The % change in PTT from late event to postepisode was significantly greater (indicating a greater change in BP) for repetitive episodes when compared with the % change from late to postevents in isolated respiratory events (P < 0.05) (Figure 2b). There was no difference between % change in PTT from late to between events in repetitive episodes compared with % change from late to postevents in isolated respiratory events. The ratio of repetitive to isolated respiratory events for each child significantly predicted the mean HR, which increased with an increasing proportion of repetitive respiratory events compared with isolated events during N1, N2, REM, and total sleep (Figure 3). There were no relationships between mean PTT and the ratio of repetitive to isolated respiratory events during wake or any sleep stage. Determinants of Percentage Change in HR and PTT From Lateto Between-Event Phases in Episodes of Repetitive Respiratory EventsResults of the multiple linear regression analysis indicate that during total sleep, the repetitive to isolated events ratio, the number of individual respiratory events per episode, the number of arousals per episode, the ratio of the duration of the respiratory event to the duration of the subsequent between event period, and sleep stage were significantly, if weakly predictive of the % change in HR from the late event phase to between the respiratory events ( Table 3). The model predicted 44% of the % change in HR from the late event phase to between the respiratory events (P < 0.01). This suggests that the more repetitive events compared with isolated events, the more episodes, the more events and arousals per episode a child has, the higher the surge in HR. In contrast, there is a negative relationship between the surge in HR and sleep stage, suggesting that the HR surge is highest during N1 and decreases during N2, N3, and REM. There is also a weak negative relationship between the surge in HR and the ratio of the duration of an event to the duration of the between event period, suggesting that the closer together the events become the % change in HR is not as great.Further analyses separating the repetitive respiratory event episodes into the sleep stage in which they occurred demonstrated that when the episodes occurred during N1 sleep, the predictive variables remained the same as for total sleep. When the episodes occurred during N2 or REM sleep, only the number of arousals in the episode predicted the change in HR (r 2 = 0.3, P < 0.01; REM: r 2 = 0.5, P < 0.001). None of the variables ...

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Polysomnographic Characteristics in Normal Preschool and Early School-Aged Children

Cited by 448 publications

References 46 publications

A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea

A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea

Sleep spindles in midday naps enhance learning in preschool children

Augmented cardiovascular responses to episodes of repetitive compared with isolated respiratory events in preschool children with sleep-disordered breathing

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