Positional obstructive sleep apnea in an obese pediatric population

Selvadurai, Sarah; Voutsas, Giorge; Massicotte, Colin; Kassner, Andrea; Katz, Sherri; Propst, Evan J.; Narang, Indra

doi:10.5664/jcsm.8496

Cited by 14 publications

(5 citation statements)

References 50 publications

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“…There were no significant differences in age, sex, or anthropometric measures between the POSA and non-POSA groups. However, older children were more likely to have POSA; 88% of the children with POSA were 12 years or older (p = 0.41) [81].…”

Section: Positional Therapymentioning

confidence: 94%

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Medical Treatment of Obstructive Sleep Apnea in Children

Ergenekon,

Gokdemir,

Ersu

2023

JCM

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Obstructive sleep apnea (OSA) is characterized by recurrent complete or partial obstruction of the upper airway. The prevalence is 1–4% in children aged between 2 and 8 years and rising due to the increase in obesity rates in children. Although persistent OSA following adenotonsillectomy is usually associated with obesity and underlying complex disorders, it can also affect otherwise healthy children. Medical treatment strategies are frequently required when adenotonsillectomy is not indicated in children with OSA or if OSA is persistent following adenotonsillectomy. Positive airway pressure treatment is a very effective modality for persistent OSA in childhood; however, adherence rates are low. The aim of this review article is to summarize medical treatment options for OSA in children.

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Section: Positional Therapymentioning

confidence: 94%

“…In positional OSA (POSA), the OSA occurs mostly while sleeping in the supine position, and this is known to affect 19-58% of children with OSA [80,81]. Obese children may have more profound upper airway obstruction during supine sleep, as greater fat deposition in the pharyngeal region results in a smaller upper airway [82].…”

Section: Positional Therapymentioning

confidence: 99%

Medical Treatment of Obstructive Sleep Apnea in Children

Ergenekon,

Gokdemir,

Ersu

2023

JCM

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“…In this report, 58% of the 112 children with obesity had POSA, and of these, 52% had mild OSA, 28% had moderate OSA, and 20% had severe OSA. Thus, among children with obesity and OAs, POSA occurs frequently [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Cluster Analysis of Home Polygraphic Recordings in Symptomatic Habitually-Snoring Children: A Precision Medicine Perspective

Zaffanello

Pietrobelli

Gozal

et al. 2022

JCM

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(1) Background: Sleep-disordered breathing (SDB) is a frequent problem in children. Cluster analyses offer the possibility of identifying homogeneous groups within a large clinical database. The application of cluster analysis to anthropometric and polysomnographic measures in snoring children would enable the detection of distinctive clinically-relevant phenotypes; (2) Methods: We retrospectively collected the results of nocturnal home-based cardiorespiratory polygraphic recordings and anthropometric measurements in 326 habitually-snoring otherwise healthy children. K-medoids clustering was applied to standardized respiratory and anthropometric measures, followed by Silhouette-based statistics. Respiratory Disturbance Index (RDI) and oxygen desaturation index (≤3%) were included in determining the optimal number of clusters; (3) Results: Mean age of subjects was 8.1 ± 4.1 years, and 57% were males. Cluster analyses uncovered an optimal number of three clusters. Cluster 1 comprised 59.5% of the cohort (mean age 8.69 ± 4.14 years) with a mean RDI of 3.71 ± 3.23 events/hour of estimated sleep (e/ehSleep). Cluster 2 included 28.5% of the children (mean age 6.92 ± 3.43 years) with an RDI of 6.38 ± 3.92 e/ehSleep. Cluster 3 included 12% of the cohort (mean age 7.58 ± 4.73 years) with a mean RDI of 25.5 ± 19.4 e/ehSleep. Weight z-score was significantly lower in cluster 3 [−0.14 ± 1.65] than in cluster 2 [0.86 ± 1.78; p = 0.015] and cluster 1 [1.04 ± 1.78; p = 0.002]. Similar findings emerged for BMI z scores. However, the height z-score was not significantly different among the 3 clusters; (4) Conclusions: Cluster analysis of children who are symptomatic habitual snorers and are referred for clinical polygraphic evaluation identified three major clusters that differed in age, RDI, and anthropometric measures. An increased number of children in the cluster with the highest RDI had reduced body weight. We propose that the implementation of these approaches to a multicenter-derived database of home-based polygraphic recordings may enable the delineation of objective unbiased severity categories of pediatric SDB. Our findings could be useful for clinical implementation, formulation of therapeutic decision guidelines, clinical management, prevision of complications, and long-term follow-up.

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“…Unfortunately, PT has not been well studied in children with the limited available literature mostly focused on children with obesity. 2…”

Section: Introductionmentioning

confidence: 99%

Positional Therapy in a Child with Down Syndrome and Obstructive Sleep Apnea: A Case Report

Rao

Hadley

2023

Preprint

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Obstructive sleep apnea (OSA) is very common in children with Down Syndrome. We report an 11-month-old female infant with Down syndrome who presented with OSA and Hypoventilation. As surgery was not indicated she was referred for institution of CPAP. As her family had concerns about CPAP, she was started on medications (nasal steroids and leukotriene antagonists) and advised Positional Therapy. Repeat sleep study in lateral position performed 7 months later showed resolution of hypoventilation and significant reduction in AHI.

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Positional obstructive sleep apnea in an obese pediatric population

Cited by 14 publications

References 50 publications

Medical Treatment of Obstructive Sleep Apnea in Children

Medical Treatment of Obstructive Sleep Apnea in Children

Cluster Analysis of Home Polygraphic Recordings in Symptomatic Habitually-Snoring Children: A Precision Medicine Perspective

Positional Therapy in a Child with Down Syndrome and Obstructive Sleep Apnea: A Case Report

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