Effects of replacement therapy on sleep architecture in children with growth hormone deficiency

Verrillo, Elisabetta; Bizzarri, Carla; Bruni, Oliviero; Ferri, Raffaele; Pavone, Martino; Cappa, Marco; Cutrera, Renato

doi:10.1016/j.sleep.2011.09.018

Cited by 8 publications

(10 citation statements)

References 38 publications

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“…Similar to what was demonstrated in the Verillo study [6], a relatively lower initial sleep time in stage R on the first study was also noted for this patient as compared with age-matched normal children. He had a baseline of 82 minutes (17.8%), which subsequently increased to 109 minutes (25.9%, + Δ 27 min) on the second study and remained relatively stable at 26.7% after his surgery on the third study (Figure 2).…”

Section: Discussionsupporting

confidence: 89%

“…A recent study by Verillo and colleagues [6] demonstrated significant sleep architecture changes—with relatively more sleep time in both stages N1 and N3 and relatively less time in stage R—for GH deficient children as compared with age-matched normal children. Confirming previous reports [7-9], they noted a significant decrease in stage N3 after GH therapy [6]. The patient in this case had comparable findings in stage N3, with a baseline of 144.5 minutes (31.4%).…”

Section: Discussionmentioning

confidence: 99%

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A Pediatric Patient with Idiopathic Short Stature Who Developed Obstructive Sleep Apnea after Starting Growth Hormone Replacement Therapy

2017

J Mol Genet Med

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BackgroundGrowth hormone (GH) therapy has long been suspected to induce obstructive sleep apnea (OSA) in children and adults. Moreover, reports about GH-associated sudden death in children with Prader-Willi syndrome (PWS) have prompted concerns about GH worsening sleep apnea. Previous studies have supported routine polysomnography for children with PWS prior to starting GH treatments, regardless of clinical history. However, there are no established guidelines recommending routine polysomnography (PSG) prior to the commencement of GH therapy in other pediatric patients.Case descriptionWe report a case of a 15-year-old young man with intractable headaches, referred to the sleep clinic to rule out any sleep-related variables. After an initial non-significant (mild snoring) sleep study, the patient returned with worsening snoring about one year after starting GH therapy for concerns of short stature.ResultsA second polysomnogram revealed that his obstructive apnea-hypopnea index had risen dramatically from baseline. His symptoms resolved after tonsillectomy and adenoidectomy.ConclusionThis interesting case highlights the need for caution with any patient eligible for GH therapy. We recommend additional research to look in the development of definitive guidelines regarding the indications for polysomnography for patients with idiopathic short stature and non-significant initial sleep history—particularly before and during the administration of GH therapy.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

A Pediatric Patient with Idiopathic Short Stature Who Developed Obstructive Sleep Apnea after Starting Growth Hormone Replacement Therapy

2017

J Mol Genet Med

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“…In the context of this review, no study has been identified to specifically investigate the link or the impact of growth hormone on sleep in healthy infants and young children. While well-characterized data on growth hormone release in association with healthy sleep pattern maturation during the first months of life are lacking,64 pediatric patients with growth hormone deficiency have been shown to display a reduced total sleep time with increased wakefulness and subsequently a decrease in sleep efficiency compared to control subjects as assessed by polysomnography 65. The relation between growth hormone and sleep in infants may not be fully understood, but a close interaction of the neuroendocrine and the chronobiological system has been shown in different populations.…”

Section: Resultsmentioning

confidence: 99%

Infant sleep and its relation with cognition and growth: a narrative review

Tham¹,

Schneider²,

Broekman³

2017

NSS

112

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ObjectiveInfant sleep development is a highly dynamic process occurring in parallel to and in interaction with cognitive and physical growth. This narrative review aims to summarize and discuss recent literature and provide an overview of the relation between infant sleep and cognitive development as well as physical growth.MethodsWe conducted online literature search using MEDLINE, Embase, and Cochrane Library databases. We considered original research on humans published in the English language from January 2005 to December 2015. Search terms included “sleep” AND “infant” AND “cognition” OR “memory” OR “executive functioning”, OR “growth” OR “obesity” OR “growth hormone” OR “stunting”, and combinations thereof.ResultsTen studies on infant sleep and cognition were included in this review. Overall, findings indicated a positive association between sleep, memory, language, executive function, and overall cognitive development in typically developing infants and young children. An additional 20 studies support the positive role of infant sleep in physical growth, with the current literature focusing largely on weight gain and obesity rather than healthy growth. Existing evidence in both the domains is mainly based on cross-sectional designs, on association studies, and on parental reports. In contrast, there were limited studies on longitudinal sleep trajectories and intervention effects, or studies have not used more objective sleep measures such as actigraphy and polysomnography.ConclusionThe reviewed studies support a critical and positive role of infant sleep in cognition and physical growth. Future studies should consider key environmental and parental confounders, include a combination of more objective (actigraphy) and subjective measures (sleep diaries and questionnaires), and move towards longitudinal trajectory designs of infant sleep and development.

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“…The same occurs when one's sleep is compromised, as the consolidation of memory and learning that occurs during sleep is not processed. Moreover, the production of growth hormone, which mainly occurs at night, is compromised.…”

Section: Discussionmentioning

confidence: 99%

Impact of untreated dental caries on the quality of life of Brazilian children: population‐based study

Lima

Santana

Paschoal

et al. 2018

Int J Paed Dentistry

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Effects of replacement therapy on sleep architecture in children with growth hormone deficiency

Cited by 8 publications

References 38 publications

A Pediatric Patient with Idiopathic Short Stature Who Developed Obstructive Sleep Apnea after Starting Growth Hormone Replacement Therapy

A Pediatric Patient with Idiopathic Short Stature Who Developed Obstructive Sleep Apnea after Starting Growth Hormone Replacement Therapy

Infant sleep and its relation with cognition and growth: a narrative review

Impact of untreated dental caries on the quality of life of Brazilian children: population‐based study

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