Literature Updates from September 2012

Effects of Positive Airway Pressure Therapy on Neurobehavioral Outcomes in Children with Obstructive Sleep Apnea

These results indicate that, despite suboptimal adherence use, there was significant improvement in neurobehavioral function in children after 3 months of positive airway pressure therapy, even in developmentally delayed children.

Changes in Neuropsychological and Behavioral Functioning in Children with and without Obstructive Sleep Apnea Following Tonsillectomy

These findings call into question the expectation that AT resolves most or all behavioral and cognitive difficulties in children with clinical, office-based diagnoses of SDB.

Challenges in Paediatric Ambulatory Anesthesia

Children with obstructive sleep apnea under 3 years of age and those with severe obstructive sleep apnea and comorbidities are not candidates for ambulatory surgery. Polysomnography has specific preoperative indications.

Orexin-A Facilitates Emergence from Propofol Anesthesia in the Rat

In rats, c-FOS positive (i.e. “active”) orexinergic neurons were reduced during propofol anesthesia, and restored during emergence. Microinjection of orexin-A into the basal forebrain caused a reduction in burst suppression ratio on EEG, and reduced time to emergence from propofol anesthesia. These results suggest that activation of orexinergic signaling plays a role in emergence from propofol anesthesia.

Role of Interleukin-6 in Stress, Sleep, and Fatigue

This review summarizes the published literature on the links between elevations of pro-inflammatory cytokine IL-6 and sleep and vice-versa.

Altered Sleep and Affect in the Neurotensin Receptor 1 Knockout Mouse

This work presents further evidence of the genetic component (expression of Ntsr1 gene) implicated in the regulation of both sleep and mood disorders.

Extracellular Levels of Lactate, but Not Oxygen, Reflect Sleep Homeostasis in the Rat Cerebral Cortex

This study presents a very elegant work that shows a role for glycolytic processes in sleep homeostasis.

Unplanned Admission After Day Surgery: A Historical Cohort Study in Patients with Obstructive Sleep Apnea

The rate of unplanned admission was 7.0% (95% confidence interval [CI] 5.1 to 8.9) in OSA patients compared with 5.6% (95% CI 4.1 to 7.1) in patients without OSA (odds ratio 1.26; 95% CI 0.83 to 1.91; P = 0.246). Median [interquartile range; IQR] hospital length of stay was 7 hr [IQR 5, 8] with OSA and 6 hr [IQR 5, 8] without OSA (P = 0.058). Severity of OSA was not associated with unplanned admission. They did not identify a clinically important increased rate of unplanned admission associated with a prior diagnosis of OSA.