Literature Updates from September 2012

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

Posted in Clinical Pediatric, Literature Updates
Posted: September 1, 2012
Authors: Marcus CL, Radcliffe J, Konstantinopoulou S, Beck SE, Cornaglia MA, Traylor J, DiFeo N, Karamessinis LR, Gallagher PR, Meltzer LJ
Contributors: Kimmo Murto
Published: Am J Respir Crit Care Med. 2012 May 1;185(9):998‑1003. Epub 2012 Feb 9.

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.

http://www.ncbi.nlm.nih.gov/pubmed

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

Posted in Clinical Pediatric, Literature Updates
Posted: September 1, 2012
Authors: Giordani B, Hodges EK, Guire KE, Ruzicka DL, Dillon JE, Weatherly RA, Garetz SL, Chervin RD
Contributors: Kimmo Murto
Published: J Int Neuropsychol Soc. 2012 Mar;18(2):212–22. Epub 2012 Jan 25.

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.

http://www.ncbi.nlm.nih.gov/pubmed/22272653

Challenges in Paediatric Ambulatory Anesthesia

Posted in Clinical Pediatric, Literature Updates
Posted: September 1, 2012
Authors: Hanna AH, Mason LJ
Contributors: Kimmo Murto
Published: Curr Opin Anaesthesiol. 2012 Jun;25(3):315–20.

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.

http://www.ncbi.nlm.nih.gov/pubmed/22552530

Orexin-A Facilitates Emergence from Propofol Anesthesia in the Rat

Posted in Clinical Adult, Literature Updates
Posted: September 1, 2012
Authors: Zhang LN, Li ZJ, Tong L, Guo C, Niu JY, Hou WG, Dong HL
Contributors: Frances Chung, Nabil Elkassabany, Stavros Memtsoudis, Ken Solt, Susana Vacas, Tajender Vasu
Published: Anesth Analg. 2012 Jul 13. [Epub ahead of print].

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.

http://www.ncbi.nlm.nih.gov/pubmed/22798527

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

Posted in Clinical Adult, Literature Updates
Posted: September 1, 2012
Authors: Rohleder N, Aringer M, Boentert M. Ann
Contributors: Frances Chung, Nabil Elkassabany, Stavros Memtsoudis, Ken Solt, Susana Vacas, Tajender Vasu
Published: N Y Acad Sci. 2012 Jul;1261(1):88–96

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

http://www.ncbi.nlm.nih.gov/pubmed/22823398

Altered Sleep and Affect in the Neurotensin Receptor 1 Knockout Mouse

Posted in Clinical Adult, Literature Updates
Posted: September 1, 2012
Authors: Fitzpatrick K, Winrow CJ, Gotter AL, Millstein J, Arbuzova J, Brunner J, Kasarskis A, Vitaterna MH, Renger JJ, Turek FW
Contributors: Frances Chung, Nabil Elkassabany, Stavros Memtsoudis, Ken Solt, Susana Vacas, Tajender Vasu
Published: Sleep. 2012 Jul 1;35(7):949–56.

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

http://www.ncbi.nlm.nih.gov/pubmed/22754041

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

Posted in Clinical Adult, Literature Updates
Posted: September 1, 2012
Authors: Dash MB, Tononi G, Cirelli C.
Contributors: Frances Chung, Nabil Elkassabany, Stavros Memtsoudis, Ken Solt, Susana Vacas, Tajender Vasu
Published: Sleep. 2012 Jul 1;35(7):909–19.

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

http://www.ncbi.nlm.nih.gov/pubmed/22754037

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

Posted in Clinical Adult, Literature Updates
Posted: September 1, 2012
Authors: Gregory L. Bryson, Claudia P. Gomez, Robert M. Jee, Josée Blackburn, Monica Taljaard & Alan J. Forster
Contributors: Frances Chung, Nabil Elkassabany, Stavros Memtsoudis, Ken Solt, Susana Vacas, Tajender Vasu
Published: Can J Anesth 2012; 59: (9) 842–85.

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.

http://www.ncbi.nlm.nih.gov/pubmed/22766625

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