Ayerspugh9601
Children with mouth breathing (MB) report poor quality of life. It is unknown whether improvement in MB is associated with improvement in behavior or quality of life. We hypothesized that in children with MB and obstructive sleep apnea (OSA), improvement in MB is associated with improvement in behavior and quality of life, independent of improvement in OSA.
This is a retrospective post hoc analysis utilizing Childhood Adenotonsillectomy Trial (CHAT) dataset, a multicenter controlled study evaluating outcomes in children with OSA randomized into early adenotonsillectomy or watchful waiting. Children with OSA and MB at baseline (determined by reporting 2 or greater to OSA-18 questionnaire on mouth breathing) were divided into 2 groups improved mouth breathing (IMB, determined by a lower score compared to baseline at follow up) and persistent mouth breathing (PMB, determined by an unchanged or higher score). Baseline characteristics, behavior (Conners GI score), sleepiness (Epworth Sleepiness Scale), and quality of life (PedsQL) were compared between the groups using appropriate statistical tests. ANCOVA models were used to analyze change in outcomes, adjusting for treatment arm and change in AHI.
Of 273 children with OSA and MB at baseline, IMB (N = 195) had significantly improved score between visits for Conner's GI Total T score, Epworth Sleepiness Scale, and PedsQL compared to PMB (N = 78), after adjusting for treatment arm and change in AHI.
Our study suggests an interesting association between mouth breathing and quality of life, independent of polysomnographic evidence. Future studies should explore the effect of mouth breathing on quality of life, in absence of OSA.
Our study suggests an interesting association between mouth breathing and quality of life, independent of polysomnographic evidence. Future studies should explore the effect of mouth breathing on quality of life, in absence of OSA.
Sleep disordered breathing (SDB) in children is commonly described as a continuum from primary snoring (PS) to obstructive sleep apnea (OSA), based on apnea indices from polysomnography (PSG). selleck kinase inhibitor This study evaluated the difference in neurocognitive and behavioral parameters, prior to treatment, in symptomatic pre-school children with PSG-diagnosed OSA and PS.
All children had positive Pediatric Sleep Questionnaire (PSQ) results and were deemed suitable for adenotonsillectomy by an ENT surgeon. Neurocognitive and behavioral data were analyzed in pre-school children at recruitment for the POSTA study (The Pre-School OSA Tonsillectomy Adenoidectomy Study). Data were compared between PS and OSA groups, with Obstructive Apnea-Hypopnea Index, OAHI < 1/h or 1-10/h, respectively.
Ninety-one children were enrolled, including 52 with OSA and 39 with PS. Distribution of IQ (using Brief Intellectual Ability, BIA) was slightly skewed towards higher values compared with the reference population. No significant differences were found in neurocognitive or behavioral parameters for children with OSA versus those with PS.
Neurocognitive and behavioral parameters were similar in pre-school children symptomatic for OSA, regardless of whetheror not PSGdiagnosed PS or OSA. Despite having identical symptoms, children with PS on PSG are often treated conservatively, whereas those with OSA on PSG are considered for adenotonsillectomy. This study demonstrates that, regardless of whetheror not PS or OSA is diagnosed on PSG, symptoms, neurocognition, and behavior are identical in these groups. We conclude that symptoms and behavioral disturbances should be considered in addition to OAHI when determining the need for treatment.
Australian and New Zealand Clinical Trials registration number ACTRN12611000021976.
Australian and New Zealand Clinical Trials registration number ACTRN12611000021976.
Sleep is an essential physiologic process whose disturbances have been regarded as a risk factor in various pathophysiologic processes, including atherosclerosis and cardiovascular disease. Although the negative influence of short sleep duration has been well-established, recent data suggest a possible harmful effect of prolonged sleeping pattern.
In the setting of the Corinthia cross-sectional study, self-reported night sleep duration was recorded in 1752 apparently healthy individuals and was classified as normal sleep duration (NSD, 7-8h), short sleep duration (SSD, 6-7h), very short sleep duration (VSSD, < 6h), and long sleep duration (LSD, > 8h). Carotid duplex ultrasonography was performed in order to measure the mean and maximum carotid intima-media thickness (cIMT) as a non-invasive marker of atherosclerosis.
Subjects with LSD and VSSD had significantly higher mean cIMT (VSSD 1.02 ± 0.45mm, SSD 0.95 ± 0.35, NSD 0.96 ± 0.38mm, LSD 1.07 ± 0.52mm; p < 0.001) and maximum cIMT (VSSD 1.39 ± 0.9mm, SSD 1.25 ± 0.71mm, NSD 1.23 ± 0.76mm, LSD 1.41 ± 0.93mm). Following a regression analysis adjusting for known cardiovascular risk factors, individuals with LSD and VSSD had higher mean cIMT by 0.054mm and 0.067mm respectively compared to those with NSD.
A balanced sleeping duration of 6-8h is associated with decreased mean and maximum IMT while both very short sleep duration and long sleep duration are associated with increased carotid intima-media thickness, a marker of subclinical atherosclerosis.
A balanced sleeping duration of 6-8 h is associated with decreased mean and maximum IMT while both very short sleep duration and long sleep duration are associated with increased carotid intima-media thickness, a marker of subclinical atherosclerosis.
Evaluate the effect of respiratory inductance plethysmography (RIP) belt design on the reliability and quality of respiratory signals. A comparison of cannula flow to disposable cut-to-fit, semi-disposable folding and disposable RIP belts was performed in clinical home sleep apnea testing (HSAT) studies.
This was a retrospective study using clinical HSAT studies. The signal reliability of cannula, thorax, and abdomen RIP belts was determined by automatically identifying periods during which the signals did not represent respiratory airflow and breathing movements. Results were verified by manual scoring. RIP flow quality was determined by examining the correlation between the RIP flow and cannula flow when both signals were considered reliable.
Of 767 clinical HSAT studies,mean signal reliability of the cut-to-fit, semi-disposable, and disposable thorax RIP belts was 83.0 ± 26.2%, 76.1 ± 24.4%, and 98.5 ± 9.3%, respectively. The signal reliability of the cannula was 92.5 ± 16.1%, 87.0 ± 23.3%, and 85.5 ± 24.