Total energy expenditure in children with obstructive sleep apnoea syndrome

Bland, Ruth; Bulgarelli, S.; Ventham, J. C.; Jackson, Diana; Reilly, John J.; Paton, James Y.

doi:10.1183/09031936.01.99104401

Cited by 44 publications

(23 citation statements)

References 27 publications

(72 reference statements)

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“…5 In another study, 46 7 children with OSDB were studied for polysomnography before and after T&A, and 3 had improvements in OAHI. Two of these children had small increases in energy expenditure, whereas the other had a small reduction in energy expenditure.…”

Section: E204mentioning

confidence: 99%

Increases in Overweight After Adenotonsillectomy in Overweight Children With Obstructive Sleep-Disordered Breathing Are Associated With Decreases in Motor Activity and Hyperactivity

et al. 2006

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OBJECTIVE. To examine the effect of adenotonsillectomy (T&A) in children with obstructive sleep-disordered breathing on growth, hyperactivity, and sleep and waking motor activity.METHODS. We studied 54 children who were aged 6 to 12 years and had adenotonsillar hypertrophy and an obstructive apnea-hypopnea index of Ն1 before and 12 months after they all received adenotonsillectomy (T&A). We measured their height, weight, percentage overweight (patient BMI Ϫ BMI at 50th percentile)/ BMI at 50th percentile * 100) and obtained a hyperactivity score from parent report on a standardized behavior questionnaire scale. A subset of 21 of these children were also studied for motor activity by wrist actigraphy for 7 consecutive days and nights before and 12 months after T&A.RESULTS. After T&A, mean obstructive apnea-hypopnea index decreased from 7.6 to 0.6. Height percentile did not change, but weight percentile increased; as a consequence, percentage overweight increased from 32.0% to 36.3%. Hyperactivity scores and total daily motor activity were reduced after T&A. From linear regression, the reduction in hyperactivity scores predicted an increase in percentage overweight. Reduced motor activity was correlated with increased percentage overweight.CONCLUSIONS. An increase in percentage overweight after T&A in children with obstructive sleep-disordered breathing is correlated to decreased child hyperactivity scores and to decreased measured motor activity in the subset studied. These associations suggest that the increase in overweight may be attributable to reductions in physical activity and fidgeting energy expenditure. (OSDB) occurs in ϳ3% of children. 1-3 Adenotonsillar hypertrophy is the most common cause of OSDB in young children, and adenotonsillectomy (T&A) is the primary treatment of obstructive sleep apnea in children. [4][5][6] OSDB in children has been associated with a variety of comorbidities, including hypertension, enuresis, poor scholastic performance, hyperactivity, and attentiondeficit/hyperactivity disorder, and these conditions are also ameliorated with successful treatment of OSDB via T&A. 7,8 OSDB has also been reported to influence somatic growth. Several studies have shown that OSDB is associated with reduced growth in height and weight 5,6,[9][10][11][12] and failure to thrive in infants. 13 These growth alterations have been related to a number of factors, including reduced secretion of growth hormone and insulinlike growth factor-I, 11,14,15 low energy intake as a result of difficulty swallowing, 16 and increased energy expenditure during sleep. 5,16 All of these factors are reported to improve after T&A. 6,11,[14][15][16] Other studies, however, have reported that growth in children with adenotonsillar hypertrophy and OSDB is normal or that these children are actually overweight before treatment. 4,17,18 After T&A, normal-weight and overweight children with or without OSDB rapidly gain weight. 17,18 Thus, although T&A has a beneficial effect on OSDB symptoms 4 and improves the other...

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Section: E204mentioning

confidence: 99%

Increases in Overweight After Adenotonsillectomy in Overweight Children With Obstructive Sleep-Disordered Breathing Are Associated With Decreases in Motor Activity and Hyperactivity

et al. 2006

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“…In the other studies there was considered a significant role for chronic adenotonsilar hypertrophy in obstructive apnea and also increased calories consumption, loss of energy and FTT was reported [21,30,31] . In our study without consideration of causes and pathophysiology of adenotonsilar hypertrophy on growth procedure (decrease in growth hormone secretion .increase in calories consumption, loss of energy and low calories intake) it focused on comparison between growth rate in children with chronic adenotonsilar hypertrophy and healthy children in the same age group (same family) and to reach this goal they used three important indexes of growth; weight, height and age in case group the weight/age ratio with standard deviation of 21.8±27.1 despite the control group that the standard deviation was 35.1±31.3.…”

Section: Resultsmentioning

confidence: 99%

“…Today it's proved that chronic adenotonsilar hypertrophy and subsequently obstruction of upper respiratory airway cause an interruption in normal growth procedure by severely reducing the secretion of growth hormone in REM phase of sleeping [16,17,18,19,20] . Finally there is some reports that obstruction of upper respiratory airway due to chronic adenotonsilar hypertrophy cause an increased calories consumption by increasing respiratory work and cause and loss of weight [21] . In addition loss of weight maybe is a result of reduced growth hormone secretion ,loss of appetite and dysphagia (low calories intake) ,nocturnal hypoxia and nocturnal acidosis [22,23] , which by the T and A operation, weight and height of the child is in normal range.…”

Section: Introductionmentioning

confidence: 99%

Evaluation Of Growth Indices In Children With Recurrent Pharyngotonsilitis Due To Adenotonsilar Hypertrophy: A Case Control Study

Mozafarinia¹

2008

American J. of Infectious Diseases

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Children in 2 to 9 years old is sensitive to growth. Chronic infectious diseases may affect on child growth and recurrent pharyngotonsilitis due to adenotonsilar hypertrophy is main disease in children and may cause failure to thrive (FTT). The aim pf this study was to investigate relation between growth rate and adenotonsillar hypertrophy in Iranian subample children. We selected 76 children between 2-9 years old who suffered from chronic adenotonsilar hypertrophy and tonsillitis more than two years evaluated and compared with normal control group, by the results of the development indices. Analysis was done by EPI-6 and SPSS-12 soft wares. According to revealed results in both groups all of percentile less than 3rd were WAP = 23.8, WHP = 17.8, HAP = 18.1 (P = 0.006) and WAP was significant difference between two groups (P = 0.045). Also there is no significant difference for WHP, WHZ, HAZ. Chronic and recurrent infection of adenotonsilar hypertrophy affecting body growth process and diminishes weight/age and height/age ratio and percentile.

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“…Opening of the airway after adenotonsillectomy affects growth in a positive way. Increase in calorie intake by increased appetite, decrease in calorie consumed at night and improvement of the function of growth hormone are involved in this (2,3,24,25,26,27,28,29).…”

Section: Discussionmentioning

confidence: 99%

Çocuklarda kronik adenotonsiller hipertrofinin büyüme üzerine etkilerinin adenotonsillektomi öncesi ve sonrası dönemde değerlendirilmesi

...

2012

Tpa

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Aim: Several factors including genetic factors, nutrition and environment play a critical role in the growth of children. Adenotonsillar hypertrophy (ATH) can cause growth retardation by obstructing the upper airway. Surgical treatment of ATH has been considered to have a positive effect on growth. The aim of this study was to evaluate the role of chronic ATH on growth by measuring weight, height, body mass index (BMI), bone age, serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) values before and after adenotonsillectomy. Material and Method: The study was approved by the Ethics Committee (4.5.2004; 04/170) and written informed consents were obtained from parents of the participants. A total of 40 prepubertal children who were diagnosed as chronic ATH were enrolled. Obstructive symptoms were questioned in the medical history before surgery. Weight, height, BMI and bone age values were measured and compared with reference values. Preoperative serum IGF-1 and IGFBP-3 values were compared with the control group which consisted of healthy children. Rates of obstructive symptoms, weight, height, BMI, bone age, serum IGF-1 and IGFBP-3 values of the patients were determined seven months after adenotonsillectomy and were compared with preoperative values. Results: Obstructive symptoms in children with ATH decreased remarkably after surgery. Preoperative mean value of bone age of the patients was statistically lower than reference values (p<0.05) and mean value of serum IGF-1 was lower than than the control group (p<0.05). IGF-1 and IGFBP-3 values did not increase significantly after surgery (p>0.05). However, growth retardation was detected in three out of 40 patients based on the anthropometric measurements. Conclusions: In this study, antropometric findings showed that chronic ATH did not cause significant growth retardation in prepubertal children. In addition, we could not prove that surgical treatment of ATH improved the growth in the postoperative follow-up period of seven months. This result may be related with our study population with a limited number of patients who had baseline growth retardation and short postoperative follow up period. Further studies with large number of patients and longer postoperative follow-up periods are required to determine the exact role of chronic ATH in growth retardation. (Turk Arch Ped 2012; 47: 257-262)

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Total energy expenditure in children with obstructive sleep apnoea syndrome

Cited by 44 publications

References 27 publications

Increases in Overweight After Adenotonsillectomy in Overweight Children With Obstructive Sleep-Disordered Breathing Are Associated With Decreases in Motor Activity and Hyperactivity

Increases in Overweight After Adenotonsillectomy in Overweight Children With Obstructive Sleep-Disordered Breathing Are Associated With Decreases in Motor Activity and Hyperactivity

Evaluation Of Growth Indices In Children With Recurrent Pharyngotonsilitis Due To Adenotonsilar Hypertrophy: A Case Control Study

Çocuklarda kronik adenotonsiller hipertrofinin büyüme üzerine etkilerinin adenotonsillektomi öncesi ve sonrası dönemde değerlendirilmesi

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