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Childhood obstructive sleep apnoea: An update

Published on Dec 1, 2004in Hong Kong Medical Journal1.588
Albert Martin Li Mb46
Estimated H-index: 46
(CUHK: The Chinese University of Hong Kong),
Dorothy F. Y. Chan13
Estimated H-index: 13
(CUHK: The Chinese University of Hong Kong)
+ 1 AuthorsYun Kwok Wing44
Estimated H-index: 44
(CUHK: The Chinese University of Hong Kong)
Abstract
To review literature on epidemiology, complications, diagnosis, and treatment of childhood obstructive sleep apnoea.Literature search of MEDLINE up to July 2004 using the following key words: 'obstructive sleep apnoea syndrome', 'children', 'epidemiology', 'complications', 'treatment', and 'polysomnography'.Literature and data related to the aspects of childhood obstructive sleep apnoea.Relevant information and data were reviewed by the authors.There is a paucity of normal data on childhood obstructive sleep apnoea. Varying definitions and diagnostic criteria have been used in different studies, making direct comparison difficult. However, a small-scale local study found that the prevalence and clinical features of this condition were similar to data published overseas. Increasing evidence suggests that childhood obstructive sleep apnoea is associated with cardiovascular morbidity and neurocognitive dysfunction. Overnight polysomnography has remained the gold standard for diagnosing obstructive sleep apnoea but the diagnostic criteria has not been standardised nor correlated with the long-term outcome. Surgical intervention has remained the treatment of choice, although alternative therapies are being evaluated.Consensus on the various important aspects of childhood obstructive sleep apnoea is still limited, especially the definition, diagnosis, and long-term sequelae of this condition. Further advances can only be made with international collaborative research, using evidence-based definitions, standardised techniques, and polysomnographic criteria.
  • References (72)
  • Citations (13)
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References72
Newest
#1Albert Martin Li Mb (CUHK: The Chinese University of Hong Kong)H-Index: 46
#2Yun Kwok Wing (CUHK: The Chinese University of Hong Kong)H-Index: 44
Last. FOKTaiFai (CUHK: The Chinese University of Hong Kong)H-Index: 50
view all 7 authors...
Background and objectives: There are limited data on the night-to-night variability of childhood sleep-related disordered breathing (SDB). We aim to assess for the presence of first-night effect (FNE) and to examine whether a single-night sleep study is adequate in the assessment of childhood SDB. Design: In a case-control study investigating whether obesity is a risk factor for childhood SDB, the night-to-night variability of sleep and respiratory variables were studied. Participants and settin...
80 CitationsSource
#1Chau Kw (Kwong Wah Hospital)H-Index: 1
#2Ng KkH-Index: 1
Last. Cheung MyH-Index: 1
view all 4 authors...
Background Obstructive sleep apnea affects up to 2. 9% of children. This study was to determine demographic and clinical characteristics of a group of children with obstructive sleep apnea syndrome (OSAS) as defined by sleep polysomnography (PSG). Methods A prospective study was conducted in a public-funded general hospital in Hong Kong of China. Children confirmed to have OSAS by PSG were followed up between January 1997 and December 1998. Tonsillectomy and adenoidectomy (T&A) was offered to th...
9 Citations
Obstructive sleep apnea causes intermittent elevation of systemic blood pressure (BP) during sleep. To determine whether obstructive apnea in children has a tonic effect on diurnal BP, 24-hour ambulatory blood pressure was obtained from 60 children with mean age of 10.8 ± 3.5 years. Thirty-nine children had obstructive apnea and 21 had primary snoring. Children with obstructive apnea had significantly greater mean BP variability during wakefulness and sleep, a higher night-to-day systolic BP, an...
261 CitationsSource
#1Shimrit Uliel (Boston Children's Hospital)H-Index: 1
#2Riva Tauman (Boston Children's Hospital)H-Index: 22
Last. Yakov Sivan (Boston Children's Hospital)H-Index: 17
view all 4 authors...
Study objectives: Polysomnography is important in the evaluation of children and adolescents with sleep-disordered breathing. Adult criteria for obstructive sleep apnea have been shown to be inapplicable to children. Nevertheless, very little data are available regarding normal respiratory parameters during sleep in healthy children and adolescents. The purpose of the study was to characterize normal polysomnography values in healthy children and adolescents and to establish respiratory referenc...
289 CitationsSource
#1Ariel TarasiukH-Index: 31
#2Tzahit SimonH-Index: 5
Last. Haim ReuveniH-Index: 23
view all 4 authors...
Objective. To investigate health care utilization of children with obstructive sleep apnea syndrome (OSAS) 1 year after adenotonsillectomy (TA 2) children who had OSAS and did not undergo surgery (n = 90); and 3) control subjects who were matched by age, sex, and area of residency (n = 520) and randomly selected from the CHS database. OSAS was verified with polysomnography studies in all patients. Indices of health care utilization were analyzed 1 year before and 1 year after T&A. Medical record...
110 CitationsSource
#1John L. KielyH-Index: 11
#2Philip NolanH-Index: 20
Last. Walter T. McNicholas (UCD: University College Dublin)H-Index: 51
view all 3 authors...
Background: Increased nasal airflow resistance (NAR) may contribute to the pathophysiology of obstructive sleep apnoea syndrome (OSAS) but studies investigating the effects of relieving nasal obstruction in OSAS have produced differing results. There are no reports of intranasal corticosteroid therapy in adult OSAS patients with reversible nasal obstruction. Methods: We evaluated an intranasal corticosteroid, fluticasone propionate, in 24 consecutive snorers with associated rhinitis using a rand...
154 Citations
134 CitationsSource
#1Yun Kwok Wing (CUHK: The Chinese University of Hong Kong)H-Index: 44
#2S. Hui (CUHK: The Chinese University of Hong Kong)H-Index: 8
Last. T.F. FokH-Index: 22
view all 7 authors...
Background: Unlike the adult sleep related disordered breathing (SDB) patients who are typically obese, the relation between obesity and childhood SDB is not clear. Aims: To investigate whether obese children are more at risk of obstructive SDB when compared to normal population, and whether this risk is potentiated by the presence of pharyngeal lymphoid tissue. Methods: Forty six obese children (age 10.8 (SD 2.3) years; BMI 27.4 (SD 5.1)), and 44 sex and age matched normal weight children (age ...
205 CitationsSource
#1Bat-Chen FriedmanH-Index: 1
Last. Asher TalH-Index: 38
view all 7 authors...
Objective: To evaluate neurocognitive functions of children with obstructive sleep apnea syndrome (OSAS), before and after adenotonsillectomy, compared with healthy controls. Design: Prospective study. Patients and Methods: Thirty-nine children with OSAS aged 5 to 9 years (mean age, 6.8 ±0.2 years) and 20 healthy children (mean age, 7.4 ± 1.4 years) who served as controls, underwent a battery of neurocognitive tests containing process-oriented intelligence scales. Twenty-seven children in the OS...
179 CitationsSource
#1K. W. ChauH-Index: 1
#2D. K. K. NgH-Index: 1
Last. J. C. S. HoH-Index: 1
view all 5 authors...
Objective: To identify the clinical factor(s) that identify obstructive sleep apnoea syndrome (OSAS) in children. Methods: A prospective study of children referred to the sleep clinic of the paediatric department was conducted in a public non-teaching regional hospital in Hong Kong. A standard questionnaire was administered and overnight sleep polysomnography was performed in a consecutive series of patients. Logistic regression analysis was performed to obtain significant risk factors for predi...
39 Citations
Cited By13
Newest
#1Alberto Caprioglio (University of Insubria)H-Index: 13
Last. Luana NosettiH-Index: 7
view all 8 authors...
Study objectives: This study wanted to evaluate the correlations between haematic cortisol levels and the craniofacial morphology in children with Obstructive Sleep Apnoea Syndrome (OSAS) in comparison with healthy children. Measurements and results: Haematic cortisol concentration at 2.00 am was found higher in OSAS patients than in controls (p<0.05). An increase in craniomandibular (p<0.05) and intermaxillar (p<0.01) angles indicated a high angle tendency in OSAS with a posterior rotation of t...
Source
Objective: Respiratory disorders related to sleeping problems are examined in a wide spectrum ranging from simple snoring to obstructive sleep apnea syndrome. Hypertension and the risk for cardiovascular morbidity because of obstructive sleep apnea syndrome have been demonstrated in many previous studies. But, there are limited number of studies demonstrating the influential blood pressure changes during the rime interval from primary snoring to obstructive sleep apnea syndrome. Methods: Twenty ...
Source
#1M. BogaertsH-Index: 1
#2Ward SchrootenH-Index: 10
Last. Peter LemkensH-Index: 5
view all 6 authors...
Key-words. Adenoidectomy, tonsillectomy, obstructive sleep apnoea syndrome Abstract. Patient reported outcome measures (PROMs) in children with sleep-disordered breathing undergoing adeno- tonsillectomy. Objectives: Patient reported outcome measures (PROMs) asses the health status or health related quality of life from the patient's perspective. The aims of this study were to assess the effect of adenotonsillectomy on symptoms and daily functioning in children with sleep-disordered breathing (SD...
1 Citations
Objective: Respiratory disorders related to sleeping problems are examined in a wide spectrum ranging from simple snoring to obstructive sleep apnea syndrome. Hypertension and the risk for cardiovascular morbidity because of obstructive sleep apnea syndrome have been demonstrated in many previous studies. But, there are limited number of studies demonstrating the influential blood pressure changes during the rime interval from primary snoring to obstructive sleep apnea syndrome. Methods: Twenty ...
#1Stefan Kuhle (U of A: University of Alberta)H-Index: 34
#2Michael S. Urschitz (Boston Children's Hospital)H-Index: 17
Background Obstructive sleep apnea (OSA) is characterized by partial or complete upper airway obstruction during sleep. Approximately 1% to 4% of children are affected by OSA, with adenotonsillar hypertrophy the most common underlying risk factor. Surgical removal of enlarged tonsils and adenoids is the most commonly used treatment for OSA. Given the perioperative risk of the intervention and an estimated recurrence rate of up to 20%, there has recently been an increased interest in non-surgical...
51 CitationsSource
#1Albert Martin Li Mb (CUHK: The Chinese University of Hong Kong)H-Index: 46
#2Hung K. So (CUHK: The Chinese University of Hong Kong)H-Index: 12
Last. Yun Kwok Wing (CUHK: The Chinese University of Hong Kong)H-Index: 44
view all 9 authors...
Objective To determine the prevalence and risk factors of obstructive sleep apnoea syndrome (OSAS) in Chinese children using a two-phase community-based study design. Methods Children from 13 primary schools were randomly recruited. A validated OSAS screening questionnaire was completed by their parents. Children at high risk of OSAS and a randomly chosen low-risk group were invited to undergo overnight polysomnographic study and clinical examination. The the sex-specific prevalence rate was mea...
92 CitationsSource
#1Cindy K Jon (University of Texas Health Science Center at Houston)H-Index: 3
Polysomnography is the gold standard test for the diagnosis of sleep-disordered breathing (SDB) in children. Pediatric polysomnography should be performed in a sleep laboratory equipped for children and staffed by qualified personnel following the American Thoracic Society (ATS) standards for testing. In 2007, the American Academy of Sleep Medicine (AASM) standardized scoring of sleep stages and definitions for sleep-disordered breathing events in children. Controversy remains regarding preopera...
5 CitationsSource
#1Andrew G. Shuman (UM: University of Michigan)H-Index: 15
#2Jason A. Heth (UM: University of Michigan)H-Index: 16
Last. Karin M. Muraszko (UM: University of Michigan)H-Index: 39
view all 5 authors...
OBJECTIVE: Craniopharyngiomas (CPs) are benign tumors that almost always occur in a suprasellar location, making complete resection difficult and often necessitating radiotherapy. A case of CP presenting in an unusual location in an 8-year-old boy highlights the goals of CP treatment. CLINICAL PRESENTATION: An 8-year-old boy sought treatment for symptoms of nasal obstruction and snoring. He also had a history of mild developmental delay, and his father had a thyroglossal duct cyst resected in hi...
12 CitationsSource
#1Tk WongH-Index: 1
Polysomnography is the standard investigation for diagnosing obstructive sleep apnoea syndrome and a wide range of sleep problems in children. The initial standards were published more than 10 years ago. Over the past decade, technology evolved rapidly. New clinical data were published. This update outlines the current standard, important changes, unanswered questions, and the future direction of development of polysomnography in children.
2 Citations