Predictors of Obstructive Sleep Apnea Severity in Adenotonsillectomy Candidates

Weinstock, Tanya G.; Rosen, Carol L.; Marcus, Carole L.; Garetz, Susan L.; Mitchell, Ron B.; Amin, Raouf S.; Paruthi, Shalini; Katz, Eliot S.; Arens, Raanan; Weng, Jia; Ross, Kristie; Chervin, Ronald D.; Ellenberg, Susan S.; Wang, Rui; Redline, Susan

doi:10.5665/sleep.3394

Cited by 138 publications

(116 citation statements)

References 37 publications

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“…Further risk factors are African American race and environmental tobacco smoke, which show significant associations with the apnea-hypopnea index in children [12].…”

Section: Introductionmentioning

confidence: 99%

Parental poverty and occupation as risk factors for pediatric sleep-disordered breathing

Friberg

Lundkvist

et al. 2015

Sleep Medicine

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“…Further risk factors are African American race and environmental tobacco smoke, which show significant associations with the apnea-hypopnea index in children [12].…”

Section: Introductionmentioning

confidence: 99%

Parental poverty and occupation as risk factors for pediatric sleep-disordered breathing

Friberg

Lundkvist

et al. 2015

Sleep Medicine

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“…Volumetric measurements suggest that the adenoids and tonsils are significantly increased in children with OSA compared with matched control subjects, concomitant with smaller upper airway and larger soft palate volumes adding additional restriction to the airway lumen size (83,84). Therapy for OSA in children may involve surgery (e.g., adenotonsillectomy), positive pressure ventilation, oral appliances, and weight normalization if indicated.…”

Section: Pediatric Obstructive Sleep Apneamentioning

confidence: 99%

An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities

Mukherjee

Patel

Kales

et al. 2015

Am J Respir Crit Care Med

223

153

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Rationale: Despite substantial public interest, few recommendations on the promotion of good sleep health exist to educate health care providers and the general public on the importance of sleep for overall health.Objectives: The aim of this American Thoracic Society (ATS) statement is to provide a review of the current scientific literature to assist health care providers, especially pulmonologists and sleep physicians, in making recommendations to patients and the general public about the importance of achieving good quality and adequate quantity of sleep.Methods: ATS members were invited, based on their expertise in sleep medicine, and their conclusions were based on both empirical evidence identified after comprehensive literature review and clinical experience.Main Results: We focus on sleep health in both children and adults, including the impact of occupation on sleep, the public health implications of drowsy driving, and the common sleep disorders of obstructive sleep apnea and insomnia. This ATS statement also delineates gaps in research and knowledge that should be addressed and lead to new focused research priorities to advance knowledge in sleep and sleep health.Conclusions: Good quality and quantity of sleep are essential for good health and overall quality of life; therefore a strong recommendation was made for the implementation of public education programs on the importance of sleep health.

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“…Prior research has demonstrated increased OSA prevalence 36 and lower CPAP adherence 13,37 in African Americans (AA). Our data demonstrate 15.0% of the study population to be AA, which is disparate from the 4.4% of the Colorado state census identified as AA in 2013 (quickfacts.census.gov).…”

Section: Inclusion Criteriamentioning

confidence: 99%

Correlates of Pediatric CPAP Adherence

Hawkins

Jensen

Simon

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Obstructive sleep apnea (OSA) is a common pediatric condition characterized by recurrent partial or complete cessation of airflow during sleep, typically due to inadequate upper airway patency. Continuous positive airway pressure (CPAP) is a therapeutic option that reduces morbidity. Despite efforts to promote use, CPAP adherence is poor in both pediatric and adult populations. We sought to determine whether demographics, insurance status, OSA severity, therapeutic pressure, or comorbid conditions were associated with pediatric CPAP adherence. Methods: A retrospective review of adherence download data was performed on all pediatric patients with initiation or adjustment of CPAP treatment over a one-year period with documented in-laboratory CPAP titration. Patients were grouped as CPAP adherent or non-adherent, where adherence was defined as > 70% nightly use and average usage ≥ 4 hours per night. Differences between the groups were analyzed by χ 2 test. Results: Overall, nearly half of participants were CPAP adherent (49%, 69/140). Of the demographic data collected (age, ethnicity, sex, insurance status), only female sex was associated with better adherence (60.9% vs 39.5% of males adherent; odds ratio [OR] = 2.41, 95%CI = 1.20-4.85; p = 0.01). Severity of OSA (diagnostic apnea-hypopnea index [AHI] and degree of hypoxemia), therapeutic pressure, and residual AHI did not impact CPAP adherence (p > 0.05). Patients with developmental delay (DD) were more likely to be adherent with CPAP than those without a DD diagnosis (OR = 2.55, 95%CI = 1.27-5.13; p = 0.007). Female patients with trisomy 21 tended to be more adherent, but this did not reach significance or account for the overall increased adherence associated with female sex. Conclusions: Our study demonstrates that adherence to CPAP therapy is poor but suggests that female sex and developmental delay are associated with better adherence. These findings support efforts to understand the pathophysiology of and to develop adherence-promoting and alternative interventions for pediatric OSA.

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Predictors of Obstructive Sleep Apnea Severity in Adenotonsillectomy Candidates

Abstract: Clinicaltrials.gov (#NCT00560859).

Cited by 138 publications

References 37 publications

Parental poverty and occupation as risk factors for pediatric sleep-disordered breathing

Parental poverty and occupation as risk factors for pediatric sleep-disordered breathing

An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities

Correlates of Pediatric CPAP Adherence

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