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Available from: Manisha Witmans, Oct 02, 2015
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    • "This threshold however was derived from a large cohort of healthy children [46], where the actual cut-off of 1 event/h referred to obstructive apnoeas only, and did not include hypopnoeas. Thus, other authors have used a cut off of 1.5 events/h [51] or 2 events/h [52]. Mild OSA is usually defined as between 1 and <5 events/h, moderate OSA when there are between 5 and <10 events/h, and severe OSA when there are >10 events/h [53]. "
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    ABSTRACT: Sleep disordered breathing (SDB) is common in children and describes a continuum of nocturnal respiratory disturbance from primary snoring (PS) to obstructive sleep apnoea (OSA). Historically, PS has been considered benign, however there is growing evidence that children with PS exhibit cognitive and behavioural deficits equivalent to children with OSA. There are two popular mechanistic theories linking SDB with daytime morbidity: hypoxic insult to the developing brain; and sleep disruption due to repeated arousals. These theories apply well to OSA, but children with PS experience neither hypoxia nor increased arousals when compared to non snoring controls. So what are we missing? This review summarises the literature examining daytime morbidity in children with PS and discusses the current debates surrounding this relationship. Specifically, questions exist as to the sensitivity of our standard assessment techniques to measure subtle hypoxia and arousal. There is also a suggestion that the association between PS and daytime morbidity may not be mediated by nocturnal respiratory disturbance at all, but by a number of other comorbid, but perhaps unrelated factors. As approximately 70% of children with SDB are diagnosed with PS, but are rarely treated, a paradigm shift in the investigation of PS may be required.
    Sleep Medicine Reviews 07/2014; 18(6). DOI:10.1016/j.smrv.2014.06.009 · 8.51 Impact Factor
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    • "OSA was defined as AHI ! 1.5 [17] [18]. Statistical significance was evaluated using a Kruskal–Wallis test for comparison of AHIs between pre-intervention, post-adenotonsillectomy, and post-VPI surgery cohorts. "
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    ABSTRACT: Otolaryngologic problems are common in the 22q11.2 deletion syndrome (DS) population. Structural anomalies and retrognathia may predispose these patients to obstructive sleep apnea (OSA). The current association of OSA in this population is not defined.
    International Journal of Pediatric Otorhinolaryngology 06/2014; 78(8). DOI:10.1016/j.ijporl.2014.05.031 · 1.19 Impact Factor
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    • "Patients were eligible for the study if their PSG ruled out the diagnosis of obstructive sleep apnea (OSA). Almost all patients were referred to PSG to rule out OSA. OSA was defined as an obstructive apnea-hypopnea index (OAHI) ≥ 1.5 events per hour [17] [18] [19] [20]. Only the patient's initial PSG was included in the study. "
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    ABSTRACT: Rationale. The sleep-related factors that modulate the nocturnal worsening of asthma in children are poorly understood. This study addressed the hypothesis that asthmatic children have a REM sleep-related vulnerability trait that is independent of OSA. Methods. We conducted a retrospective cross-sectional analysis of pulse-oximetry signals obtained during REM and NREM sleep in control and asthmatic children (n = 134). Asthma classification was based on preestablished clinical criteria. Multivariate linear regression model was built to control for potential confounders (significance level P ≤ 0.05). Results. Our data demonstrated that (1) baseline nocturnal respiratory parameters were not significantly different in asthmatic versus control children, (2) the maximal % of SaO2 desaturation during REM, but not during NREM, was significantly higher in asthmatic children, and (3) multivariate analysis revealed that the association between asthma and REM-related maximal % SaO2 desaturation was independent of demographic variables. Conclusion. These results demonstrate that children with asthma have a REM-related vulnerability trait that impacts oxygenation independently of OSA. Further research is needed to delineate the REM sleep neurobiological mechanisms that modulate the phenotypical expression of nocturnal asthma in children.
    10/2013; 2013:406157. DOI:10.1155/2013/406157
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