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    ABSTRACT: ABBREVIATIONS ACTB Arizona Cognitive Test Battery AHI Apnea–hypopnea index IED Intra-extra dimensional set shift OSAS Obstructive sleep apnea syn-drome PSG Polysomnography AIM Good-quality sleep is essential for normal learning and memory. Sleep fragmentation and disrupted sleep architecture are commonly observed throughout the lifespan of individuals with Down syndrome, a condition marked by cognitive deficits emerging within the first few months of life. While obstructive sleep apnea syndrome (OSAS) is known to contribute to the loss of sleep quality in Down syndrome, its relation to cognitive and behavioral impairment remains poorly understood. METHOD Using ambulatory polysomnography, we measured sleep in an unreferred
    Developmental Medicine & Child Neurology 01/2014; · 2.68 Impact Factor
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    ABSTRACT: Objectives:In contrast to obstructive sleep apnea (OSA), central sleep apnea (CSA) has received lesser attention in the obese children. Because pediatric CSA is more prevalent than expected and adversely impacts health, this study aims to elucidate the major factors associated with central apnea index (CAI), and compare CSA between obese and non-obese children.Methods:Retrospective analysis was performed in a tertiary referral medical center. Children with sleep disordered breathing (SDB) ranging from 2 to 18 years old were enrolled. All participants completed history taking, otolaryngological examination, and overnight polysomnography. CSA was defined as having CAI exceeding 1/hr. CAI and the prevalence of CSA were analyzed in children of different age groups, weight statuses, and adenotonsillar sizes.Results:A total of 487 cases were included. The prevalence of CSA was 13.3% (65/487). CAI was negatively correlated with age (r=-0.32, P<0.001). Obese children had a significantly lower CAI than that of non-obese ones (0.20±0.36/hr vs 0.48±0.82/h, P<0.001). Multiple linear regression analysis demonstrated a relationship among CAI, age, and obesity by 'CAI=0.883-0.055 × Age -0.22 × (Obesity)'.Conclusions:In children with SDB, younger ones have a significantly higher CAI than older ones. Additionally, obese children had a lower CAI than non-obese ones.International Journal of Obesity accepted article preview online, 19 September 2013. doi:10.1038/ijo.2013.184.
    International journal of obesity (2005) 09/2013; · 5.22 Impact Factor
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    ABSTRACT: The recent scoring rules of the American Academy of Sleep Medicine (AASM) define hypoventilation in children as a carbon dioxide (CO2) level of >50 mmHg for >25 % of total sleep time (partial pressure of CO2 (PCO2) > 50[>25 %]). As there is no validated level of nocturnal hypoventilation with regard to end-organ damage in children, we evaluated the prevalence of hypoventilation with the AASM definition but also with a lesser degree of elevated CO2 in children with sleep-disordered breathing (SDB). Transcutaneous CO2 (PtcCO2) was recorded during overnight polygraphy (PG). Hypoventilation was defined according to four definitions: the AASM score (PCO2 > 50[>25 %]), the peak value of PtcCO2 > 50 mmHg (PtcCO2 > 50[peak]), a percentage of PtcCO2 > 50 mmHg > 2 % of nighttime recording (PtcCO2 > 50[>2 %]) or a nocturnal PtcCO2 > 10 mmHg above waking baseline level (PtcCO2[>10 mmHg]). PtcCO2 indices were correlated to the apnoea-hypopnoea index (AHI) and oxygenation indices. PGs from 221 children with suspicion of obstructive sleep apnoea (72 %), neuromuscular diseases (21 %), and lung diseases (7 %) were analysed. The prevalence of hypoventilation according to PCO2 > 50[>25 %], PtcCO2 > 50[peak], PtcCO2 > 50[>2 %] and PtcCO2[>10 mmHg] were 16, 27, 31 and 52 %, respectively, and did not differ between the three diagnostic groups. Significant but weak correlations were observed between hypoventilation and AHI and oxygenation indices. Nocturnal hypoventilation occurs in a large number of children referred for SDB, independent of the underlying disease, when more stringent criteria than those of the AASM are used. The poor correlation between hypoventilation and AHI or oxygenation indices is in favour of CO2 being a supplemental index of SDB.
    Sleep And Breathing 04/2014; · 2.26 Impact Factor

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