Diagnostic capability of questionnaires and clinical examinations to assess sleep-disordered breathing in children

Canto, Graziela De Luca; Singh, Vandana; Major, Michael P.; Witmans, Manisha; El‐Hakim, Hamdy; Major, Paul W.; Flores-Mir, Carlos

doi:10.14219/jada.2013.26

Cited by 70 publications

(66 citation statements)

References 49 publications

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“…Sufficient evidence has been already gathered to suggest that all orthodontic patients, adult or pediatric, should undergo an evaluation of the risk of OSAS using validated questionnaires, as a form of screening 52 . Studies in sleep medicine have increasingly highlighted the importance of the orthodontist in the early diagnosis of this syndrome, because the oral cavity has several signs that potentially indicate an increased risk of this syndrome, such as the Mallampati classification.…”

Section: Discussionmentioning

confidence: 99%

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)

Brunetto

Sant'Anna

Machado

et al. 2017

Dental Press J. Orthod.

143

103

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Introduction: Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE). Objective: The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA).Methods: All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained.Conclusion: It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)

Brunetto

Sant'Anna

Machado

et al. 2017

Dental Press J. Orthod.

143

103

View full text Add to dashboard Cite

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“…(54) The Scale itself has been highlighted by several reviews as one of the most appropriate instruments developed for this purpose. (57, 58)…”

Section: Discussionmentioning

confidence: 99%

Sleep-Disordered Breathing, Sleep Duration, and Childhood Overweight: A Longitudinal Cohort Study

Bonuck¹,

Chervin²,

Howe³

2015

The Journal of Pediatrics

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Objectives To examine independent associations between sleep-disordered breathing (SDB), sleep duration from birth through 6.75 years, and body mass index (BMI) through 15 years of age in a population-based cohort. Study design The Avon Longitudinal Study of Parents and Children (ALSPAC) collected parent questionnaire data on child sleep duration and sleep disordered breathing (SDB) symptoms from birth through 6.75 years and child BMI from ALSPAC research clinics (n=1,899). For SDB, logistic regression models-- minimal, confounder, and confounder + sleep duration adjusted-- examined associations with BMI at 7, 10, and 15 years. For short sleep duration (≤ 10th centile), comparable SDB-adjusted models examined associations with BMI at 15 years. Results Children with the worst SDB symptoms vs. asymptomatic children, had increased odds of overweight at 7 (OR=2.08, 95% CI= 1.04-4.17), 10 (OR= 1.79, 95% CI= 1.02-3.16), and 15 years (OR= 2.25, 95% CI= 1.27-3.97) in models adjusted for sleep duration. Similarly, short sleep duration at ≈5-6 years was associated with overweight at 15 years, independent of SDB. Children with short sleep duration at 4.75 years were more likely to be overweight at 15 years in minimally (OR= 2.21, 95% CI= 1.52-3.20), confounder (OR= 1.99, 95% CI= 1.34-2.96), and SDB-adjusted (OR= 2.04, 95% CI= 1.36=3.04) models. Conclusion Both SDB and short sleep duration significantly and independently increase children’s odds of becoming overweight. Findings underscore the potential importance of early identification and remediation of SDB, along with insufficient sleep, as strategies for reducing childhood obesity.

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“…[21][22][23][24][25] Three reviews of pediatric questionnaires by other groups concluded that the PSQ may be the best pediatric OSA instrument available apart from PSG for sleepdisordered breathing. [30][31][32] A recent publication showed that in contrast to PSG, PSQ better reflects subjective measures of OSA-related impairment of behavior, quality of life and sleepiness and predicts their improvement after adenotonsillectomy. As for OSA, the PSQ showed a sensitivity of 77% to 81% and a specificity of 87% compared to PSG.…”

Section: Discussionmentioning

confidence: 99%

Adenoidectomy for Obstructive Sleep Apnea in Children

Domany

Dana

Tauman

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objective: Adenotonsillectomy is the recommended treatment for children with obstructive sleep apnea (OSA). Since adenoidectomy alone may be associated with significantly lower morbidity, mortality, and cost, we aimed to investigate whether adenoidectomy alone is a reasonable and appropriate treatment for children with OSA. Methods: Five-hundred fifteen consecutive children diagnosed with moderate-to-severe OSA (apnea-hypopnea index > 5) based on polysomnography and who underwent adenoidectomy or adenotonsillectomy were reevaluated after 17-73 months (mean 41) for residual or recurrent OSA using a validated questionnaire (Pediatric Sleep Questionnaire, PSQ). Failure of OSA resolution was defined as a positive mean PSQ score ≥ 0.33. Contribution of age, obesity, tonsil size, and OSA severity at baseline to adenoidectomy or adenotonsillectomy failure was examined. Results: Positive PSQ score occurred in 15% of the entire sample and was not influenced by age or gender. No difference in failure rate was observed between adenoidectomy and adenotonsillectomy for children who were not obese with apnea-hypopnea index < 10 and had small tonsils (< 3). Children with apnea-hypopnea index ≥ 10 and/or tonsil size ≥ 3 showed a higher failure rate after adenoidectomy compared to adenotonsillectomy (20% versus 9.8%, p = 0.028). Conclusions:We suggest that subjective, long term outcomes of adenoidectomy are comparable to those of adenotonsillectomy in non-obese children under 7 years old with moderately OSA and small tonsils. Hence, adenoidectomy alone is a reasonable option in some children. Future prospective randomized studies are warranted to define children who may benefit from adenoidectomy alone and those children in whom adenoidectomy alone is unlikely to succeed.

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Diagnostic capability of questionnaires and clinical examinations to assess sleep-disordered breathing in children

Cited by 70 publications

References 49 publications

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)

Sleep-Disordered Breathing, Sleep Duration, and Childhood Overweight: A Longitudinal Cohort Study

Adenoidectomy for Obstructive Sleep Apnea in Children

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