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    ABSTRACT: Rationale: Children with the obstructive sleep apnea syndrome (OSAS) have impaired cortical processing of respiratory afferent stimuli, manifested by blunted sleep respiratory-related evoked potentials (RREP). However, whether this impairment is limited to respiratory stimuli, or reversible after successful treatment, is unknown. We hypothesized that, during sleep, children with OSAS have (i) abnormal RREP; (ii) normal cortical processing of non-respiratory stimuli, and (iii) persistence of abnormal RREP following treatment. Objectives: To measure sleep RREP and auditory evoked potentials (AEP) in normal controls and children with OSAS before and after treatment. Methods: 24 children with OSAS and 24 controls were tested during N3 sleep. Thirteen children with OSAS repeated testing 4-6 months after adenotonsillectomy. Measurements and Main Results: RREP were blunted in OSAS compared to controls (N350 at Cz, -27 ±15.5 vs. -47.4 ±28.5 µV, p= 0.019), and did not improve after OSAS treatment (N350 at Cz pre-treatment -25.1±7.4 vs. -29.8 ± 8.1 post-treatment). AEP were similar in OSAS and controls at baseline (N350 at Cz -58 ±33.1 vs. -66 ±31.1 µV), and did not change after treatment (N350 at Cz -67.5 ±36.8 vs. -65.5 ± 20.3). Conclusions: Children with OSAS have persistent primary or irreversible respiratory afferent cortical processing deficits during sleep that could put them at risk of OSAS recurrence. OSAS does not appear to affect the cortical processing of non-respiratory (auditory) afferent stimuli during sleep.
    American Journal of Respiratory and Critical Care Medicine 08/2013; · 11.04 Impact Factor
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    ABSTRACT: Sleep-disordered breathing in general and particularly, obstructive sleep apnea syndrome (OSAS) are highly prevalent conditions in children. Current diagnostic approaches range from exclusively using clinical presentation and physical examination to the current "Gold Standard" of overnight polysomnography (NPSG). But while it is clear that the former is fraught with major limitations, the latter is also associated with significant obstacles, such as relative unavailability of appropriately equipped sleep laboratories and trained personnel, the labor intensive nature of NPSG and its inconvenience, and, of course, the high cost of the procedure. These limitations are detrimental to timely diagnosis and treatment. Novel approaches to the evaluation of community-based and clinically referred pediatric populations are discussed and should stimulate the field in the search for improved diagnostic technologies and delineation of a more pragmatic and reliable diagnostic approach for pediatric SDB.
    Sleep Medicine 08/2010; 11(7):708-13. · 3.49 Impact Factor
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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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