Paediatric origins of adult lung diseases bullet 3: The genesis of adult sleep apnoea in childhood

McNamara, Frances; Sullivan, Colin E.

doi:10.1136/thorax.55.11.964

Cited by 29 publications

(19 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…). Indeed, the potential genesis of adult sleep apnoea in early life has been suggested by other authors (McNamara & Sullivan, ), in keeping with a wider recognition in recent years of the developmental origins of adult disease. We acknowledge, however, the need for cautious extrapolation of the findings of our study to human disorders.…”

Section: Discussionsupporting

confidence: 64%

Early life exposure to chronic intermittent hypoxia causes upper airway dilator muscle weakness, which persists into young adulthood

McDonald

Williams

Sheehan

et al. 2015

Experimental Physiology

View full text Add to dashboard Cite

New Findings r What is the central question of this study?Chronic intermittent hypoxia (CIH) is a dominant feature of respiratory control disorders, which are common. We sought to examine the effects of exposure to CIH during neonatal development on respiratory muscle form and function in male and female rats. r What is the main finding and its importance?Exposure to CIH during neonatal development caused sternohyoid muscle weakness in both sexes; an effect that persisted into young adult life upon return to normoxia. Upper airway dilator muscle dysfunction in vivo could predispose to airway collapse, leading to impaired respiratory homeostasis.Chronic intermittent hypoxia (CIH) is a feature of sleep-disordered breathing, which is very common. Exposure to CIH is associated with aberrant plasticity in the respiratory control system including the final effector organs, the striated muscles of breathing. We reasoned that developmental age and sex are key factors determining the functional response of respiratory muscle to CIH. We tested the hypothesis that exposure to CIH causes persistent impairment of sternohyoid muscle function due to oxidative stress and that males are more susceptible to CIH-induced muscle impairment than females. Wistar rat litters (with respective dams) were exposed to intermittent hypoxia for 12 cycles per hour, 8 h per day for 3 weeks from the first day of life [postnatal day (P) 0]. Sham experiments were run in parallel. Half of each litter was studied on P22; the other half was returned to normoxia and studied on P42. Functional properties of the sternohyoid muscle were determined ex vivo. Exposure to CIH significantly decreased sternohyoid muscle force in both sexes; an effect that persisted into young adult life. Chronic intermittent hypoxia had no effect on sternohyoid muscle endurance. Chronic intermittent hypoxia did not affect sternohyoid myosin fibre type, succinate dehydrogenase or glycerol-3-phosphate dehydrogenase activities, or protein free thiol and carbonyl content. Muscles exposed to CIH had smaller cross-sectional areas, consistent with the observation of muscle weakness. In human infants with disordered breathing, CIH-induced upper airway dilator muscle weakness could increase the propensity for airway narrowing or collapse, which could serve to perpetuate impaired respiratory homeostasis.

show abstract

Section: Discussionsupporting

confidence: 64%

Early life exposure to chronic intermittent hypoxia causes upper airway dilator muscle weakness, which persists into young adulthood

McDonald

Williams

Sheehan

et al. 2015

Experimental Physiology

View full text Add to dashboard Cite

show abstract

“…In the USA, 0.1% of children 2 to 18 years old are obese, and 5 to 18% are overweight 25 , 26 . The prevalence of OSA among obese children is highly variable 18 , 27 , 28 . In a review study, Verhulst et al 29 found that the frequency of OSA among obese children varied between 13 and 59%.…”

Section: Discussionmentioning

confidence: 99%

Clinicals And Upper Airway Characteristics in Obese Children with Obstructive Sleep Apnea

et al. 2017

View full text Add to dashboard Cite

IntroductionObesity is a factor that is strongly related to the occurrence of obstructive sleep apnea (OSA) in adults, although this association remains controversial for children.ObjectiveThe aim of this study was to compare the clinical and upper airway charactheristics, obtained by questionnaires, physical examination and laboratory tests, among obese children with and without OSA.MethodThis was aprospective cohort study. 44 obese children (body mass index above the 95th percentile) were included in the study. Questionnaires, physical examination of the upper airway, nasofibrolaryngoscopy, polysomnography, and laboratory allergic tests were performed.ResultsThere were 22 male patients (50%), and the mean age was 7.6±2.5 years. OSA was present in 19 (43%) patients. There were no statistically significant differences between the groups with and without OSA, in relation to clinical or laboratory allergic parameters. For the upper airway assessments, hypertrophy of the pharyngeal (p=0.001) and palatine (p=0.049) tonsils were the only parameters associated with OSA, and a modified Mallampati index of class III/IV also demonstrated a tendency towards being statistically associated with OSA (p=0.081). Moreover, these findings were confirmed to be factors associated with OSA in this group of children according to a logistic regression analysis.ConclusionsThe occurrence rate of OSA in this obese pediatric population was high. Adenotonsillar hypertrophy and a modified Mallampati index of class III/IV were the factors associated with OSA.

show abstract

“…For Indigenous children already disadvantaged in so many ways, recognition of this problem and its subsequent management intervention may be particularly important, in order to prevent or further reduce the likelihood of low school achievement. Another potential consequence of OSA, of relevance to many groups of Indigenous children, is the possibility of long‐term heart disease 33 . With rheumatic fever and rheumatic heart disease still common causes of morbidity and mortality in Indigenous Australians 34 , obstructive sleep‐related disorders may also be contributory to the list of risk factors for heart disease.…”

Section: Discussionmentioning

confidence: 99%

Snoring and its association with asthma in Indigenous children living in the Torres Strait and Northern Peninsula Area

Valery

Masters

Chang

2004

J Paediatrics Child Health

View full text Add to dashboard Cite

We conclude that the prevalence of symptoms suggestive of obstructive sleep problems is relatively high in children of this region. This highlights the need for awareness among the community patients and physicians about the problem of obstructive sleep-disordered breathing, especially in children with asthma, and for the need for further studies to measure prevalence of sleep breathing disorders among Indigenous Australians.

show abstract

Paediatric origins of adult lung diseases bullet 3: The genesis of adult sleep apnoea in childhood

Cited by 29 publications

References 88 publications

Early life exposure to chronic intermittent hypoxia causes upper airway dilator muscle weakness, which persists into young adulthood

Early life exposure to chronic intermittent hypoxia causes upper airway dilator muscle weakness, which persists into young adulthood

Clinicals And Upper Airway Characteristics in Obese Children with Obstructive Sleep Apnea

Snoring and its association with asthma in Indigenous children living in the Torres Strait and Northern Peninsula Area

Contact Info

Product

Resources

About