Screening Severe Obstructive Sleep Apnea in Children with Snoring

Hsieh, Hui‐Shan; Kang, Chung Jan; Chuang, Hai Hua; Zhuo, Ming Ying; Lee, Guo She; Huang, Yu; Chuang, Li‐Pang; Kuo, Terry B.J.; Yang, Cheryl C.H.; Lee, Li‐Ang; Li, Hsueh Yu

doi:10.3390/diagnostics11071168

Cited by 8 publications

(8 citation statements)

References 64 publications

(84 reference statements)

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“…Notably, there has been an 80% decrease in the diagnosis and management of OSAS worldwide during the COVID−19 pandemic [ 59 ]. A 3% oxygen desaturation index ≥6.0 events/h using a home sleep pulse oximeter can predict severe disease in OSAS children with an acceptable accuracy of 82% [ 60 ]. Of note, mean SpO 2 is also measured by pulse oximetry.…”

Section: Discussionmentioning

confidence: 99%

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Chuang

Hsu

Wang

et al. 2021

IJERPH

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Older age, obesity, and obstructive sleep apnea syndrome (OSAS) are known to increase the risk of hypertension in adults. However, data for children are scarce. This study aimed to investigate the relationships between hypertension, age, weight status, and disease severity in 396 children with OSAS. The prevalence rates of hypertension, obesity, and severe OSAS (apnea-hypopnea index ≥10) were 27.0%, 28.0%, and 42.9%, respectively. Weight z-score and apnea-hypopnea index were independently correlated with systolic blood pressure z-score, and minimal blood oxygen saturation (SpO2) was independently associated with diastolic blood pressure z-score. Overall, late childhood/adolescence (odds ratio (OR) = 1.72, 95% CI = 1.05–2.81), obesity (OR, 2.58, 95% CI = 1.58–4.22), and severe OSAS (OR = 2.38, 95% CI = 1.48–3.81) were independent predictors of pediatric hypertension. Furthermore, late childhood/adolescence (OR = 2.50, 95% CI = 1.10–5.71) and abnormal SpO2 (mean SpO2 < 95%; OR = 4.91, 95% CI = 1.81–13.27) independently predicted hypertension in obese children, and severe OSAS (OR = 2.28, 95% CI = 1.27–4.10) independently predicted hypertension in non-obese children. In conclusion, obesity, OSAS severity, and abnormal SpO2 are potentially modifiable targets to improve hypertension while treating children with OSAS.

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Section: Discussionmentioning

confidence: 99%

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Chuang

Hsu

Wang

et al. 2021

IJERPH

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“…The children were further divided into 2 OSAS severity subgroups according to AHI, as severe OSAS (≥10.0 events/h) and nonsevere OSAS (<10.0 events/h) 24 ; 2 desaturation subgroups based on ODI3, as severe desaturation (≥6.0 events/h) and nonsevere desaturation (<6.0 events/h) 25 ; 2 subgroups of sleep hypoxemia according to mean SpO 2 , as sleep hypoxemia (<95.0%) and no sleep hypoxemia (≥95.0%) 26 ; and 2 subgroups of IH according to minimal SpO 2 , as significant IH (<85.0%) and nonsignificant IH (≥85%) 27 . These cut‐off values of AHI, mean SpO 2 , and minimal SpO 2 have been reported to be significantly associated with hypertension in children with OSAS 4 …”

Section: Methodsmentioning

confidence: 99%

Effect of Preoperative Weight Status and Disease Presentation on Postoperative Elevated Blood Pressure After Childhood Adenotonsillectomy

Hsieh

Chuang

Hsin

et al. 2023

Otolaryngol.--head neck surg.

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Objective To investigate the risk factors of postoperative elevated blood pressure (BP) in children with childhood obstructive sleep apnea syndrome (OSAS) after adenotonsillectomy (AT). Study Design Case series with planned data collection. Setting Tertiary referral center. Methods Two hundred forty‐five consecutive children (180 boys and 65 girls, median age 6.6 years) with polysomnography‐diagnosed OSAS who underwent AT between January 2010 and August 2019. Clinical, polysomnographic, and evening BP data were assessed preoperatively and postoperatively (≥3 months after AT). Changes in the variables before and after AT and between individuals with and without hypertension were compared. Results Postoperatively, the median (interquartile range) apnea‐hypopnea index significantly decreased from 10.4 (5.3‐22.6) to 2.2 (1.0‐3.8) events/h. In addition, the mean (standard deviation) evening diastolic BP z‐score significantly decreased from 0.7 (0.94) to 0.5 (0.81) in the overall cohort, and both systolic (2.1 [0.94]‐1.0 [1.31]) and diastolic BP z‐scores (1.6 [0.98]‐0.7 [0.85]) significantly decreased in the preoperative elevated BP subgroup. Multivariate logistic regression analysis showed that preoperative obesity (adjusted odds ratio = 4.36, 95% confidence interval = 2.24‐8.49) and mean peripheral oxygen saturation <95% during sleep (adjusted odds ratio = 2.73, 95% confidence interval = 1.29‐5.79) were independently associated with postoperative elevated BP. Conclusion Preoperative obesity and mean peripheral oxygen saturation <95% during sleep were significantly associated with postoperative elevated BP in the children with OSAS, further indicating the importance of careful BP monitoring in this subgroup despite AT treatment.

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“…[ 31 ]. In a population of children with snoring that was investigated by Hsieh Hui-Shan, screening consisting of home sleep pulse oximetry combined with adenoidal-nasopharyngeal ratio (ANR) showed higher effectiveness than ANR and tonsil size [ 32 , 33 ]. Furthermore, there was positive correlation between the accident statuses of drivers with OSAS severity based on data acquired in a study by Celikhisar H. [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

Change in the Constricted Airway in Patients after Clear Aligner Treatment: A Retrospective Study

Fountoulaki

Thurzo

2022

Diagnostics

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This retrospective study evaluated changes in the pharyngeal portion of the upper airway in patients with constricted and normal airways treated with clear aligners (Invisalign, Align). Additionally, we assessed the change of tongue position in the oral cavity from a lateral view. Evaluation was performed with specialized software (Invivo 6.0, Anatomage) on pretreatment and post-treatment pairs of cone beam computed tomography imaging (CBCT) data. The level of airway constriction, volume, cross-section minimal area and tongue profile were evaluated. Patients with malocclusion, with pair or initial and finishing CBCT and without significant weight change between the scans, treated with Invisalign clear aligners were distributed into two groups. Group A consisted of fifty-five patients with orthodontic malocclusion and constricted upper airway. Control group B consisted of thirty-one patients with orthodontic malocclusions without any airway constriction. In the group with airway constriction there was a statistically significant increase in volume during therapy (p < 0.001). The surface of the most constricted cross-section of the airway did not change significantly after treatment in any of the groups. The final tongue position was different from the initial position in 62.2% of all clear aligner treatments. The position of the smallest clearance of the airway in the pharynx was similar for both groups localized at the level of 2nd cervical vertebra.

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Screening Severe Obstructive Sleep Apnea in Children with Snoring

Cited by 8 publications

References 64 publications

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Effect of Preoperative Weight Status and Disease Presentation on Postoperative Elevated Blood Pressure After Childhood Adenotonsillectomy

Change in the Constricted Airway in Patients after Clear Aligner Treatment: A Retrospective Study

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