Updates on management of pediatric obstructive sleep apnea

Yu, Jason L.; Afolabi‐Brown, Olufunke

doi:10.1002/ped4.12164

Cited by 11 publications

(8 citation statements)

References 87 publications

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“…1). Although FIS1 is believed to be one of the DRP1 adaptor proteins, recent evidence suggests that FIS1 may instead regulate mitochondrial morphology by inhibition of fusion [38]. In addition, several reports have suggested that FIS1 may be important for mitochondrial quality control by stimulating mitophagy [39,40].…”

Section: Discussionmentioning

confidence: 99%

Human skeletal muscle mitochondrial dynamics in relation to oxidative capacity and insulin sensitivity

et al. 2020

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Aims/hypothesis Mitochondria operate in networks, adapting to external stresses and changes in cellular metabolic demand and are subject to various quality control mechanisms. On the basis of these traits, we here hypothesise that the regulation of mitochondrial networks in skeletal muscle is hampered in humans with compromised oxidative capacity and insulin sensitivity. Methods In a cross-sectional design, we compared four groups of participants (selected from previous studies) ranging in aerobic capacity and insulin sensitivity, i.e. participants with type 2 diabetes (n = 11), obese participants without diabetes (n = 12), lean individuals (n = 10) and endurance-trained athletes (n = 12); basal, overnight fasted muscle biopsies were newly analysed for the current study and we compared the levels of essential mitochondrial dynamics and quality control regulatory proteins in skeletal muscle tissue. Results Type 2 diabetes patients and obese participants were older than lean participants and athletes (58.6 ± 4.0 and 56.7 ± 7.2 vs 21.8 ± 2.5 and 25.1 ± 4.3 years, p < 0.001, respectively) and displayed a higher BMI (32.4 ± 3.7 and 31.0 ± 3.7 vs 22.1 ± 1.8 and 21.0 ± 1.5 kg/m2, p < 0.001, respectively) than lean individuals and endurance-trained athletes. Fission protein 1 (FIS1) and optic atrophy protein 1 (OPA1) protein content was highest in muscle from athletes and lowest in participants with type 2 diabetes and obesity, respectively (FIS1: 1.86 ± 0.79 vs 0.79 ± 0.51 AU, p = 0.002; and OPA1: 1.55 ± 0.64 vs 0.76 ± 0.52 AU, p = 0.014), which coincided with mitochondrial network fragmentation in individuals with type 2 diabetes, as assessed by confocal microscopy in a subset of type 2 diabetes patients vs endurance-trained athletes (n = 6). Furthermore, lean individuals and athletes displayed a mitonuclear protein balance that was different from obese participants and those with type 2 diabetes. Mitonuclear protein balance also associated with heat shock protein 60 (HSP60) protein levels, which were higher in athletes when compared with participants with obesity (p = 0.048) and type 2 diabetes (p = 0.002), indicative for activation of the mitochondrial unfolded protein response. Finally, OPA1, FIS1 and HSP60 correlated positively with aerobic capacity (r = 0.48, p = 0.0001; r = 0.55, p < 0.001 and r = 0.61, p < 0.0001, respectively) and insulin sensitivity (r = 0.40, p = 0.008; r = 0.44, p = 0.003 and r = 0.48, p = 0.001, respectively). Conclusions/interpretation Collectively, our data suggest that mitochondrial dynamics and quality control in skeletal muscle are linked to oxidative capacity in humans, which may play a role in the maintenance of muscle insulin sensitivity. Clinical Trial registry numbers NCT00943059, NCT01298375 and NL1888

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Section: Discussionmentioning

confidence: 99%

Human skeletal muscle mitochondrial dynamics in relation to oxidative capacity and insulin sensitivity

et al. 2020

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“…However, it is still controversial whether sedation mimics real sleep. It is the reality of the physiological information determined in another discussion [27].…”

Section: Clinical Examinationmentioning

confidence: 97%

“…It is based on the multi-channel recording principle during sleep in accredited sleep laboratories. A typical montage would include several electroencephalography (EEG) channels, chin and anterior tibial electromyography (EMG), bilateral electrooculography, pulse oximeter and pulse waveform, nasal pressure transducer, oronasal airflow thermistor, end-tidal capnography, chest and abdominal respiratory inductance plethysmography, body position sensor, microphone, and real-time synchronized video monitoring [27].…”

Section: Psgmentioning

confidence: 99%

Obstructive Sleep Apnea in Children: ENT Perspective

Günel¹,

Başal²,

Sih³

2021

Pediatric ENT Infections

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“…Because of this, other interventions should be considered in this population. Continuous Positive Airway Pressure (CPAP) therapy is a treatment for those with OSAS, who are not surgical candidates, or who have residual OSA despite T&A [ 17 , 18 ]. CPAP has been shown to be effective and safe in children [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

The Use of Auto-Titrating Continuous Positive Airway Pressure (AutoCPAP) for Obstructive Sleep Apnea Syndrome in Children with Obesity

2021

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Background: Positive airway pressure can be an effective and safe therapy for children with obstructive sleep apnea syndrome (OSAS). Few studies have assessed the safety and efficacy of autoCPAP in pediatric patients with obesity. Methods: This was a retrospective chart review of children with obesity (Body Mass Index (BMI) > 99th percentile), ages 2–18, diagnosed with OSAS (Obstructive Apnea-Hypopnea Index (OAHI) > 1/h) and used autoCPAP with 30-day adherence. Exclusion criteria included patients with complex comorbidities. Adherence was defined as autoCPAP use ≥4 h/night for at least 21/30 days. Baseline PSG OAHI was compared to the AHI from the 30-day autoCPAP compliance report. We also compared autoCPAP 30-day 95th percentile pressures with the pressures from PAP titration. Results: The study included 19 children, ranging 5–15 years old. The median BMI was 99.6th percentile and average adherence was 25/30 nights with mean of 7.3 h/night. The median OAHI was 12.3/h on baseline PSG and the 30-day autoCPAP download AHI decreased to 1.7/h. No adverse outcomes were identified. The average difference between 95th percentile autoCPAP pressure and PAP titration pressure was 0.89 cmH20. Conclusion: Our study suggests autoCPAP is effective and safe for the treatment of OSAS in pediatric patients with obesity. Using autoCPAP may reduce delays in treatment. Additional research is needed to verify the long-term effectiveness of autoCPAP in this population.

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Updates on management of pediatric obstructive sleep apnea

Cited by 11 publications

References 87 publications

Human skeletal muscle mitochondrial dynamics in relation to oxidative capacity and insulin sensitivity

Human skeletal muscle mitochondrial dynamics in relation to oxidative capacity and insulin sensitivity

Obstructive Sleep Apnea in Children: ENT Perspective

The Use of Auto-Titrating Continuous Positive Airway Pressure (AutoCPAP) for Obstructive Sleep Apnea Syndrome in Children with Obesity

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