Literature Updates from March 2018

Clinical application of MRI-respiratory gating technology in the evaluation of children with obstructive sleep apnea hypopnea syndrome

“Stenosis of the nasopalatine pharyngeal cavity in children with adenoidal hypertrophy was greatest at the end-expiration phase during sleep. The end-expiratory Sa/Snp obtained by a combination of MRI and respiratory gating technology has potential as an important imaging index for diagnosing and evaluating severity in pediatric OSAHS.”

The Adenoid Microbiome in Recurrent Acute Otitis Media and Obstructive Sleep Apnea

“Microbes are present on all adenoid specimens, though the microbial profile differs between recurrent AOM and OSA. The clinical significance of these differences remains to be determined.”

Intermittent nocturnal hypoxia and metabolic risk in obese adolescents with obstructive sleep apnea

“Intermittent nocturnal hypoxia rather than the OAHI was associated with metabolic risk in obese youth after adjusting for WHtR. Measures of abdominal adiposity such as WHtR should be considered in future studies that evaluate the impact of OSA on metabolic health.” comment in PubMed Commons below

Mandibular advancement appliances for sleep-disordered breathing in children: A randomized crossover clinical trial

“Wearing an Active MAS overnight, over a short period can be beneficial for SDB children, resulting in a clinically relevant reduction of supine AHI.”

Cardioventilatory Control in Preterm Born Children and the Risk of Obstructive Sleep Apnea

“The risk for OSA could be stratified according to controller gain, plant gain, cardiorespiratory coupling and gestational age. These findings could guide a personalized care to children at risk for OSA.”

Severe obstructive sleep disorders in Prader-Willi syndrome patients in southern Italy

“OSA was the predominant sleep-related disorder in our PWS patients, not associated with age or obesity, and appeared more severe than previously reported. Further studies addressing the underlying mechanisms are necessary in larger study populations to better design the most appropriate clinical approach.” What is Known: • Sleep-related patterns and their management are very limited in patients with Prader-Willi syndrome. What is New: • Severe obstructive sleep apnoea is the most frequent sleep-related disorder in our case series.

Increased Incidence of Obstructive Sleep Apnea in Hospitalized Children following Enterovirus Infection: A Nationwide Population-Based Cohort Study

Children with severe EV infection (i.e. requiring hospitalization) carry a significantly higher risk of developing OSA, particularly in those with allergic rhinitis. As pediatric obstructive sleep apnea is a treatable sleep disorder, we emphasize regular follow-up and early detection in children with EV infection.

Convergent validity of actigraphy with polysomnography and parent reports when measuring sleep in children with Down syndrome

Our current data suggest that actigraph watches demonstrate convergent validity and are sensitive to measuring certain sleep constructs (duration, efficiency) in children with Down syndrome. However, parent reports, such as the Children’s Sleep Habits Questionnaire, may be measuring other sleep constructs. These findings highlight the importance of selecting measures of sleep related to target concerns

An updated review of pediatric drug-induced sleep endoscopy

DISE is a safe and useful technique to assess levels of obstruction in children. There is currently no universally-accepted anesthetic protocol or scoring system for pediatric DISE, but both will be necessary in order to provide a consistent method to report findings, enhance communication among providers and optimize surgical outcomes.

Devices for Ambulatory Monitoring of Sleep-Associated Disorders in Children with Neurological Diseases

This work summarizes the current literature on ambulatory sleep devices for detecting sleep disorders in children with neurological diseases.