Learning in children and sleep disordered breathing: Findings of 
the Tucson Children's Assessment of Sleep Apnea (TuCASA) 
Prospective Cohort Study

Kaemingk, Kristine L.; Pasvogel, Alice; Goodwin, James L.; Mulvaney, Shelagh A.; Martínez, Fernanda Verana Barragán; Enright, Paul; Rosen, Gerald M.; Morgan, Wayne J.; Fregosi, Ralph F.; Quan, Stuart F.

doi:10.1017/s1355617703970056

Cited by 151 publications

(123 citation statements)

References 27 publications

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“…In the present study, the AHI was adopted for the diagnosis and classification of OSAS for the following reasons: first, because it is relatively uncommon to observe complete obstruction of the upper airways in children; second, because in a study involving OSAS children (diagnosed on the basis of the AHI), the authors reported that the children in which hypopnea was not accompanied by desaturation events had low cognitive scores (6) ; third, because in this same study, the children in which hypopnea was accompanied by desaturation events presented arterial hypertension.…”

Section: Resultsmentioning

confidence: 99%

Prevalência da apneia obstrutiva do sono em crianças e adolescentes portadores da anemia falciforme

Salles¹,

Ramos

Daltro

et al. 2009

J. bras. pneumol.

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Objective: To estimate the prevalence of obstructive sleep apnea syndrome (OSAS) in children and adolescents with sickle cell anemia (SCA); to investigate the possible correlation between mean annual hemoglobin level and total sleep time with SpO 2 < 90%, as well as between mean annual hemoglobin level and total sleep time with SpO 2 < 80%; and to investigate the possible correlation between apnea-hypopnea index (AHI) and painful crisis. Methods: The study involved 85 patients with SCA. The patients completed a questionnaire, were submitted to polysomnography and underwent clinical evaluation (by a pediatrician and an otolaryngologist). An AHI > 1 was considered indicative of a diagnosis of OSAS. Results: The prevalence of OSAS was 10.6%. We found a negative correlation between mean annual hemoglobin level and total sleep time with SpO 2 < 90% (r = −0.343; p = 0.002), as well as between mean annual hemoglobin level and total sleep time with SpO 2 < 80% (r = −0.270; p = 0.016). There was no association between AHI and painful crisis. Conclusions: The prevalence of OSAS in this population was high (10.6%). Therefore, it is important to identify signs of OSAS as soon as possible and to determine the mean annual hemoglobin level because of the inverse correlation between that level and the total sleep time with SpO 2 < 90% or < 80%.Keywords: Prevalence; Sleep apnea, obstructive; Anemia, sickle cell; Polysomnography; Sleep apnea syndromes. ResumoObjetivo: Estimar a prevalência da síndrome da apneia obstrutiva do sono (SAOS) em crianças e adolescentes com anemia falciforme (AF) e investigar a possível correlação entre hemoglobina anual média e tempo total de sono com SpO 2 < 90% e tempo total de sono com SpO 2 < 80%, assim como investigar a possível correlação entre o índice de apneia-hipopneia (IAH) e episódios de crise álgica. Métodos: Participaram 85 pacientes com AF, que responderam a um questionário, foram avaliados por um pediatra e um otorrinolaringologista, e submetidos a estudo polissonográfico. O diagnóstico de SAOS foi definido como IAH > 1. Resultados: A prevalência da SAOS foi 10,6%. Observou-se uma correlação negativa entre hemoglobina anual média e tempo total de sono com SpO 2 < 90% (r = −0,343; p = 0,002) e tempo total de sono com SpO 2 < 80% (r = −0,270; p = 0,016). Não foi observada associação entre IAH e episódios de crise álgica. Conclusões: A prevalência da SAOS nesta população foi alta (10,6%). Portanto, é importante identificar precocemente os sinais de SAOS e avaliar hemoglobina anual média, devido à correlação inversa entre essa e o tempo total de sono com SpO 2 < 90% ou < 80%.

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Section: Resultsmentioning

confidence: 99%

Prevalência da apneia obstrutiva do sono em crianças e adolescentes portadores da anemia falciforme

Salles¹,

Ramos

Daltro

et al. 2009

J. bras. pneumol.

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“…In this study, the mean IQ in the OSAS population was significantly above the standard mean. Some [32][33][34] but not all studies showed a correlation between the severity of obstructive apnea as measured on PSG and increasing neuropsychological morbidity. There are several reasons why correlations were not found for all studies.…”

Section: Cognitive Deficitsmentioning

confidence: 98%

“…[32][33][34]39 Cognitive deficits associated with pediatric SDB include general intelligence level as well as processes measured by using IQ subtests (Table 8). Specific functions objectively measured by using neuropsychological assessments and included in the research studies include:…”

Section: Cognitive Deficitsmentioning

confidence: 99%

Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome

Marcus¹,

Brooks²,

Ward³

et al. 2012

Pediatrics

1,468

1,504

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OBJECTIVE: This technical report describes the procedures involved in developing recommendations on the management of childhood obstructive sleep apnea syndrome (OSAS). METHODS: The literature from 1999 through 2011 was evaluated. RESULTS AND CONCLUSIONS: A total of 3166 titles were reviewed, of which 350 provided relevant data. Most articles were level II through IV. The prevalence of OSAS ranged from 0% to 5.7%, with obesity being an independent risk factor. OSAS was associated with cardiovascular, growth, and neurobehavioral abnormalities and possibly inflammation. Most diagnostic screening tests had low sensitivity and specificity. Treatment of OSAS resulted in improvements in behavior and attention and likely improvement in cognitive abilities. Primary treatment is adenotonsillectomy (AT). Data were insufficient to recommend specific surgical techniques; however, children undergoing partial tonsillectomy should be monitored for possible recurrence of OSAS. Although OSAS improved postoperatively, the proportion of patients who had residual OSAS ranged from 13% to 29% in low-risk populations to 73% when obese children were included and stricter polysomnographic criteria were used. Nevertheless, OSAS may improve after AT even in obese children, thus supporting surgery as a reasonable initial treatment. A significant number of obese patients required intubation or continuous positive airway pressure (CPAP) postoperatively, which reinforces the need for inpatient observation. CPAP was effective in the treatment of OSAS, but adherence is a major barrier. For this reason, CPAP is not recommended as first-line therapy for OSAS when AT is an option. Intranasal steroids may ameliorate mild OSAS, but follow-up is needed. Data were insufficient to recommend rapid maxillary expansion.

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“…Sleep fragmentation and sleep-disordered breathing may adversely impact on a child's cognitive performance, learning and memory, and academic learning [10]. As a result these children may also experience excessive daytime sleepiness and/or hyperactivity [29].…”

Section: Leisure Participation 14mentioning

confidence: 99%

Leisure participation for school-aged children with Down syndrome

Oates¹,

Bebbington²,

Bourke³

et al. 2011

Disability and Rehabilitation

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Purpose. To describe leisure participation for school-aged children with Down syndrome and to investigate how factors, classified by the World Health Organisation\u27s International Classification of Functioning, Disability and Health, influence their leisure participation. Method. Families in Western Australia with a child aged 5–18 years with Down syndrome were surveyed in a population-based study (n == 208) in 2004. Results. One-third of parents reported that their child with Down syndrome had no friends although half reported two or more friends. Factors affecting number of friendships included the child\u27s functional ability, behavioural issues and parent\u27s availability of time. Those children with higher functional independence scores in daily tasks were more likely to have two or more friends than those with lower functional independence scores (OR: 1.02, 95%% CI 1.01–1.04 for a single point increase in WeeFIM score). All children participated in predominantly solitary and sedentary leisure activities. Conclusions. Leisure participation was affected by complex factors both within and external to the child with Down syndrome. Further investigation of the relevance of these factors to leisure may enable more satisfying and meaningful participation in leisure for school-aged children with Down syndrome

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Learning in children and sleep disordered breathing: Findings of the Tucson Children's Assessment of Sleep Apnea (TuCASA) Prospective Cohort Study

Cited by 151 publications

References 27 publications

Prevalência da apneia obstrutiva do sono em crianças e adolescentes portadores da anemia falciforme

Prevalência da apneia obstrutiva do sono em crianças e adolescentes portadores da anemia falciforme

Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome

Leisure participation for school-aged children with Down syndrome

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