Age-stratified sex differences in polysomnographic findings and pharyngeal morphology among children with obstructive sleep apnea

Inoshita, Ayako; Kasai, Takatoshi; Matsuoka, Rina; Sata, Naoko; Shiroshita, Nanako; Kawana, Fusae; Kato, Megumi; Ikeda, Katsuhisa

doi:10.21037/jtd.2018.11.09

Cited by 25 publications

(11 citation statements)

References 33 publications

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“…Tonsil hypertrophy was significantly increased the risk of OSA by 3.5 times. 27 Other study has shown that there is a significant correlation between adeno-tonsillar hypertrophy and OSA in pre-adolescents than in adolescents. Our results were in agreement with the statement that the upper respiratory tract area and the adenoidal-nasopharyngeal (A/N) ratio were not significantly different in the pre-adolescent group.…”

Section: Discussionmentioning

confidence: 92%

“…Hence, the operative treatment for children with OSA is primarily tonsillectomy, sometimes accompanied by adenoidectomy. 27 Oxygen free radicals released from asthmatics' airways regulate 5-lipoxygenase activity in pharyngeal lymphoid tissue, triggering the synthesis of cysteinyl leukotriene, causing tonsilloadenoid hypertrophy. 8 Tonsil hypertrophy is one of the pathological links between intermittent upper airway obstruction during sleep and repeated episodes of lower airway obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Commonly, clinicians conclude that obese children with similar adenotonsillar size with non-bese children, have a higher AHI than non-obese children. 27 Obesity affects breathing mechanically and physiologically. Fat deposition causes constriction of the upper respiratory tract, increases airway resistance, and causes airway collapse.…”

Section: Discussionmentioning

confidence: 99%

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The impact of obstructive sleep apnea on quality of life in children with asthma

Garina

Yunus

Timan

et al. 2022

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Background In children with asthma, obstructive sleep apnea (OSA) is a comorbidity of concern. The presence of OSA has been associated with asthma exacerbations and decreased quality of life. Leukotriene played a role in tonsil hypertrophy which is one of the risk factors for OSA. Objective To evaluate the influence of OSA on quality of life in children with asthma. Methods This cross-sectional study in asthmatic children aged 7?15 years was conducted from August 2020 to June 2021 at government elementary and primary high schools in Bandung, West Java, Indonesia. Asthma was diagnosed by peak expiratory flow rate (PEFR) and OSA was diagnosed by polysomnography. Leukotriene was examined by an ELISA method and quality of life assessed by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Results Using the ISAAC questionnaire distributed through teachers to parents, 206 (6.9%) of 2,964 children stated that they had been diagnosed with asthma, 80 of whom were included in our study. Subjects’ mean age was 12 (SD 2) years and most were male. Intermittent asthma and history of allergy was dominant. Thirty-two children had OSA, mostly mild OSA. The mean level of leukotriene was not different between asthmatic children with and without OSA. The percentage of PEFR in asthmatic children with OSA was significantly lower than in those without OSA. The total PAQLQ score in asthmatic children with OSA and all PAQLQ domains were significantly lower than in those without OSA. Conclusion Obstructive sleep apnea in children with asthma is significantly associated with decreased peak expiratory flow rate and lower quality of life.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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The impact of obstructive sleep apnea on quality of life in children with asthma

Garina

Yunus

Timan

et al. 2022

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“…This could be possibly attributed to the small sample as well as the onset of OSAS in childhood. Gender differences in the prevalence of OSAS occur from adolescence and henceforth, due to mainly anatomical differentiations in the UA 39 , whereas during childhood, boys and girls demonstrate similar OSAS severity, indicating different pathophysiology 40 . In fact, adenotonsillar hypertrophy is the main cause of OSAS in prepubertal children, regardless of the gender 41 .…”

Section: Discussionmentioning

confidence: 99%

Sleep disordered breathing from preschool to early adult age and its neurocognitive complications: A preliminary report

Astara¹,

Siachpazidou²,

Vavougios³

et al. 2021

Sleep Sci

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Objective:The onset and development of sleep disordered breathing (SDB) remains unclear in an age -dependent manner. Despite treatment, persistent symptoms such as snoring and excessive daytime sleepiness, as well as cognitive impairment may be present. The aim of the research was to determine the prevalence of residual symptoms of SDB in adolescence and early adulthood, the predisposing factors and its neurocognitive complications. Methods: In the present pilot studycohort, a questionnaire was utilized to 154 people (average age: 17.9 ± 3), who as children (mean age: 5.3 ± 1.4) had AHI ≥2.5 episodes/h. They were divided into two groups based on AHI = 5 episodes/h. Depending on the results, they were invited to undergo a repeated polysomnography (PSG) and complete the Montreal Cognitive Assessment (MoCA) test. Statistical analysis was made with IBM SPSS software. Results: Out of the total, 35.7% claimed to still snore. AHI was negatively correlated to the severity of residual symptoms (Mann-Witney U test, p <0.005). According to repeated PSGs, 9/17 met the criteria for OSAS, while high BMI was associated with the severity of new AHI (chi squared test, p<0.005). Additionally, 7/16 scored below the MoCA baseline (<26/30). The characteristics of cognitive declines were mapped, with most prominent having been visuospatial, short -term memory and naming/language deficits. Discussion: A significant percentage of children with sleep breathing disorder present with residual symptoms during their transition to early adulthood, as well as undiagnosed neurocognitive complications. Clinicians suspicion for the underlying neurocognitive complications is required, even in young adults, while guidelines on monitoring pediatric OSAS patients after treatment should be addressed.

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“…It could be explained by hormonal changes due to puberty, because OSA is more prevalent in male adults. 49 50 Since our study group was limited to 13-year-old patients, they probably were not under hormonal effects yet.…”

Section: Discussionmentioning

confidence: 99%

Long-term Impact of Adenotonsillectomy on the Quality of Life of Children with Sleep-disordered breathing

Caixeta

Sampaio

Costa

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.

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Age-stratified sex differences in polysomnographic findings and pharyngeal morphology among children with obstructive sleep apnea

Cited by 25 publications

References 33 publications

The impact of obstructive sleep apnea on quality of life in children with asthma

The impact of obstructive sleep apnea on quality of life in children with asthma

Sleep disordered breathing from preschool to early adult age and its neurocognitive complications: A preliminary report

Long-term Impact of Adenotonsillectomy on the Quality of Life of Children with Sleep-disordered breathing

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