Defining and Promoting Pediatric Pulmonary Health: Understanding Sleep and Ventilatory Health

Williamson, Ariel A.; Amin, Raouf S.; Meltzer, Lisa J.; Laposky, Aaron; Fiks, Alexander G.; Tapia, Ignacio E.

doi:10.1542/peds.2023-062292d

Cited by 3 publications

(2 citation statements)

References 85 publications

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“…Obstructive Sleep Apnea is the most severe form of Breathing Sleep Disorder (BSD) [1]. OSA is present in both adults and children and must be diagnosed and treated early to avoid acute, behavioral, learning, and cardiac problems and prevent late complications such as cardiovascular disease, Type 2 Diabetes, and metabolic syndrome [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Cytokines and Obstructive Sleep Apnea in Childhood: Study of a Group of Children

Nosetti,

Tirelli,

Marino

et al. 2024

Biologics

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Introduction: Obstructive Sleep Apnea (OSA) in children is characterized by repeated episodes of partial or complete obstruction of the upper airways that impair normal ventilation and cause hypoxia and sleep disruption. These episodes activate innate and adaptive immunity resulting in the production of proinflammatory cytokines: IL-1β, IL-6, TNF-α, and reactive oxygen species. The hypothalamic–pituitary–adrenal (HPT) axis is also activated with alteration of the circadian rhythm of cortisol synthesis. OSA in children, and even more in adults, induces a systemic inflammatory condition that contributes to the genesis of clinical complications: poor growth, learning disabilities, cardiovascular changes, insulin resistance, and metabolic syndrome. Methods: A total of 42 non-obese children (age 1–15 years) were enrolled among those sent to our sleep center to perform full polysomnography (PSG). After PSG, 6 children did not show OSA (controls), 20 had mild OSA (m OSA), and 16 had medium-severe OSA (MS OSA). In vitro IL-1β, TNF-α, and serum cortisol levels were measured at 2 and 8 am in the analyzed groups. Results: Cortisol levels did not differ between controls and OSA children. At 2 am, there were no differences between controls and OSA in TNF-α production, whereas at 8 am, TNF-α was reduced in MS-OSA. IL-1β production showed no differences between OSA and controls. Conclusions: In our population, only TNF-α production is suppressed in MS-OSA: this might indicate a role of OSA severity in inducing inflammation. In adults, the phenomenon is more pronounced due to the habitual greater severity/duration of OSA, presence of comorbidities (cardiovascular and metabolic), and different immune system function.

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Section: Introductionmentioning

confidence: 99%

“…The diagnosis of OSA can be suspected clinically based on clinical history, which should always include some questions about sleep quality, and physical examination [2]. Daytime symptoms such as behavioral problems, learning difficulties, and hyperactivity are common among these children [6,[15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Cytokines and Obstructive Sleep Apnea in Childhood: Study of a Group of Children

Nosetti,

Tirelli,

Marino

et al. 2024

Biologics

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Initiatives to improve lung and sleep health in children: Delphi consensus from the pediatrics, pulmonary, and sleep conference

DeBoer,

Smith,

Williamson

et al. 2024

Pediatric Pulmonology

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Background and ObjectivesThe lung and sleep health of adults is heavily influenced by early factors, both genetic and environmental; therefore, optimizing respiratory health begins in childhood. Multiple barriers impede improvements in lung and sleep health for children. First, the traditional siloing between general pediatric care in the community, pediatric pulmonary and sleep subspecialty care, and the research community limits the translation of knowledge into practice. Additionally, identifying and addressing health disparities remains a challenge. The 2021 NHLBI‐sponsored workshop “Defining and Promoting Pediatric Pulmonary Health (DAP3H)” was a first step in defining critical gaps in our current healthcare system in identifying and optimizing lung and sleep health in children. The workshop identified key opportunities including measuring pulmonary function in young children, sleep‐focused outcomes, developing biomarkers, and longitudinal research cohorts. To expand on the work of DAP3H and continue initiatives to improve childhood lung and sleep health, the Pediatrics & Pulmonary Network: Improving Health Together conference was held in 2023.Study DesignA modified Delphi process was applied to form consensus surrounding gaps, barriers, and action items, with the goal of identifying the most urgent opportnities for improving childhood lung and sleep health.ResultsCross‐cutting foundational principles were identified as: (1) Authentic Stakeholder Collaboration & Engagement, (2) Reach & Implementation in Real World Settings, (3) Understanding Current Landscape & Resources and (4) Purposeful Diversity, Equity, & Inclusion Initiatives.ConclusionsTo improve lung and sleep health in children, these principles should be the foundation for research design, development, and implementation.

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Defining and Promoting Pediatric Pulmonary Health: A NHLBI Workshop Executive Summary

Chmiel,

Natarajan,

Banerjee

et al. 2023

Pediatrics

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Defining and Promoting Pediatric Pulmonary Health: Understanding Sleep and Ventilatory Health

Cited by 3 publications

References 85 publications

Cytokines and Obstructive Sleep Apnea in Childhood: Study of a Group of Children

Cytokines and Obstructive Sleep Apnea in Childhood: Study of a Group of Children

Initiatives to improve lung and sleep health in children: Delphi consensus from the pediatrics, pulmonary, and sleep conference

Defining and Promoting Pediatric Pulmonary Health: A NHLBI Workshop Executive Summary

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