Dataset Information

Nasopharyngeal Width and Its Association With Sleep-Disordered Breathing Symptoms in Children.

ABSTRACT: OBJECTIVES:Although adenotonsillar hypertrophy is the main cause of sleep-disordered breathing in children, surrounding anatomic factors, such as the width of the nasopharynx, can affect upper airway patency. However, there have been no reports of the association of nasopharyngeal width with sleep-disordered breathing in children. This study was undertaken to measure nasopharyngeal width in children undergoing adenotonsillectomy for sleep-disordered breathing and to investigate the clinical implications of this factor. METHODS:This was a retrospective study with a follow-up period of 1 year, performed at a tertiary referral center. We reviewed the operative records of children who underwent adenotonsillectomy at our center for symptoms of sleepdisordered breathing, such as snoring, apnea, and mouth breathing. The nasopharyngeal width was measured immediately before adenotonsillectomy, which was performed under general anesthesia with a microscopy-assisted mirror view. Adenotonsillar hypertrophy was graded on a four-point scale, and symptoms of sleep-disordered breathing were evaluated by using the Korean version of the Obstructive Sleep Apnea-18 questionnaire before and after surgery. The relationships between the average nasopharyngeal width and patient age and sex, adenotonsillar hypertrophy, and the Korean version of the Obstructive Sleep Apnea-18 score were analyzed. RESULTS:The study included 549 children (343 boys) with a mean age of 6.0 years (range, 2 to 11 years). The average nasopharyngeal width was 11.9 mm (range, 7.0 to 18.0 mm) and increased with age (range, 11.2 to 13.3; ?=0.264; P< 0.001). At 1 year after surgery, children with a greater nasopharyngeal width at the time of surgery exhibited additional improvements in symptoms of obstruction relative to those at 1 month after surgery. CONCLUSION:The average nasopharyngeal width in children is approximately 11.9 mm and exhibits a slight increase with age. The width of the nasopharynx may be a factor associated with the degree of improvement in symptoms of sleepdisordered breathing after adenotonsillectomy.

SUBMITTER: Lee SY

PROVIDER: S-EPMC6787469 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Nasopharyngeal Width and Its Association With Sleep-Disordered Breathing Symptoms in Children.

Lee Sang-Youp SY Kim Jeong-Whun JW

Clinical and experimental otorhinolaryngology 20190306 4

<h4>Objectives</h4>Although adenotonsillar hypertrophy is the main cause of sleep-disordered breathing in children, surrounding anatomic factors, such as the width of the nasopharynx, can affect upper airway patency. However, there have been no reports of the association of nasopharyngeal width with sleep-disordered breathing in children. This study was undertaken to measure nasopharyngeal width in children undergoing adenotonsillectomy for sleep-disordered breathing and to investigate the clini ...[more]

PMID: 30832459

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Project description:BackgroundChildren with Down syndrome (DS) are at increased risk of sleep-disordered breathing (SDB). We investigated sleep spindle activity, as a marker of sleep quality, and its relationship with daytime functioning in children with DS compared to typically developing (TD) children.MethodsChildren with DS and SDB (n = 44) and TD children matched for age, sex and SDB severity underwent overnight polysomnography. Fast or Slow sleep spindles were identified manually during N2/N3 sleep. Spindle activity was characterized as spindle number, density (number of spindles/h) and intensity (density × average duration) on central (C) and frontal (F) electrodes. Parents completed the Child Behavior Check List and OSA-18 questionnaires.ResultsIn children with DS, spindle activity was lower compared to TD children for F Slow and F Slow&Fast spindles combined (p < 0.001 for all). Furthermore, there were no correlations between spindle activity and CBCL subscales; however, spindle activity for C Fast and C Slow&Fast was negatively correlated with OSA-18 emotional symptoms and caregiver concerns and C Fast activity was also negatively correlated with daytime function and total problems.ConclusionsReduced spindle activity in children with DS may underpin the increased sleep disruption and negative effects of SDB on quality of life and behavior.ImpactChildren with Down syndrome (DS) are at increased risk of sleep-disordered breathing (SDB), which is associated with sleep disruption affecting daytime functioning. Sleep spindles are a sensitive marker of sleep quality. We identified for the first time that children with DS had reduced sleep spindle activity compared to typically developing children matched for SDB severity. The reduced spindle activity likely underpins the more disrupted sleep and may be associated with reduced daytime functioning and quality of life and may also be an early biomarker for an increased risk of developing dementia later in life in children with DS.

Project description:Study objectivesTo examine the association between maternal sleep disordered breathing (SDB) and glucose metabolism in early gestation.MethodsWomen with body mass index (BMI) ≥27 kg/m2 and singleton pregnancies underwent in-home sleep study (HSAT) and homeostatic model assessment (HOMA) in early pregnancy. Insulin resistance (HOMA-IR) and β-cell function (HOMA %B) were derived. Exclusion criteria included pregestational diabetes, use of continuous positive airway pressure and chronic steroid therapy. We performed linear regression analyses to evaluate the association between continuous measures of SDB (respiratory event index (REI), and oxygen desaturation index (ODI)) and glucose metabolism parameters (HOMA-IR and HOMA %B). Analyses were adjusted for a set of a priori selected variables which included gestational age, maternal age, BMI, ethnicity, race, and parity.ResultsOne hundred and ninety-two pregnant women with median (interquartile range) BMI of 35.14 (8.30) kg/m2 underwent HSAT and HOMA assessment at 11.14 (3) and 15.35 (4.14) gestational weeks, respectively. REI and ODI, as continuous values, were associated with HOMA-IR after adjusting for covariates. OSA (obstructive sleep apnea) diagnosis (REI > 5 events per hour) was not associated with HOMA-IR after adjusting for BMI (p ≥ 0.05). None of the parameters were associated with HOMA %B (p > 0.07).ConclusionsSDB and insulin resistance are associated in early pregnancy, with a dose response association between respiratory event index severity and insulin resistance. Further studies are needed to establish if pregnant women with overweight and obesity may benefit from early SDB screening to improve glucose metabolic outcome. Clinical trials: NCT02412696, Positive Airway Pressure, Sleep Apnea, and the Placenta (PAP-SAP) https://clinicaltrials.gov/ct2/show/NCT02412696?term=Bourjeily&draw=2&rank=2 and NCT02917876, Predictors of De-novo Development of Obstructive Sleep Apnea in Pregnancy (Predictors) https://clinicaltrials.gov/ct2/show/NCT02917876?term=Bourjeily&draw=2&rank=1.

Dataset Information

Nasopharyngeal Width and Its Association With Sleep-Disordered Breathing Symptoms in Children.

Publications

Nasopharyngeal Width and Its Association With Sleep-Disordered Breathing Symptoms in Children.

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