Search

Background Rhinitis and obstructive sleep apnea (OSA) often coexist during childhood. To delineate this clinical association, we examined OSA severity and polysomnogram (PSG) features in children with rhinitis and OSA. Given that rapid-eye-movement (REM) sleep is characterized by nasal congestion, we hypothesized that children with rhinitis have more REM-related breathing abnormalities. Methods We conducted a retrospective cross-sectional analysis of 145 children with PSG-diagnosed A. Outcomes included PSG parameters and obstructive apnea–hypopnea index (OAHI) during REM and non-REM. Linear multivariable models examined the joint effect of rhinitis and OSA parameters with control for potential confounders. Results Rhinitis was present in 43% of children with OSA (n = 63) but overall OAHI severity was unaffected by the presence of rhinitis. In contrast, OAHI during REM sleep in children with moderate-severe OSA was significantly increased subjects with rhinitis and OSA (44.1/hr; SE = 6.4) compared with those with OSA alone (28.2/hr; SE = 3.8). Conclusion Rhinitis is highly prevalent in children with OSA. Although OSA is not more severe in children with rhinitis, they do have a distinct OSA phenotype characterized by more REM-related OSA. Further research is needed to delineate the link between REM-sleep and the physiology of the nose during health and disease.

Background Asthma and obstructive sleep apnea (OSA) often coexists during childhood. To delineate this clinical association, we investigated the phenotypical features of OSA in asthmatic children. Specifically, we hypothesized that asthmatic children have a distinct OSA phenotype that involves a higher prevalence of Rapid-Eye-Movement (REM)-related breathing abnormalities relative to children with OSA alone. Methods We conducted a retrospective cross-sectional analysis of 141 children aged 2–12 years with OSA diagnosed by polysomnography (PSG) in our sleep center. Outcomes included PSG parameters, maximal %SaO2 REM desaturations and prevalence of REM-related OSA. Multivariate linear regression model or logistic regression model was built to study the joint effect of asthma and OSA parameters with control for potential confounders (significance level P

The diagnosis of obstructive sleep apnea (OSA) relies on polysomnography (PSG), a multidimensional biosignal recording that is conducted in sleep laboratories. Standard PSG montage involves the use of nasal-oral airflow sensors to visualize cyclic episodes of upper airflow interruption, which are considered diagnostic of sleep apnea. Given the high-cost and discomfort associated with in-laboratory PSG, there is an emergent need for novel technology that simplifies OSA screening and diagnosis with less expensive methods. The main goal of this project was to identify novel OSA signatures based on the spectral analysis of thoraco-abdominal motion channels. Our main hypothesis was that proper spectral analysis can detect OSA cycles in adults using simultaneous recording of oxygen saturation (SaO2) and either, chest or abdominal motion. A sample study on 35 individuals was conducted with statistically significant results that suggest a strong relationship between airflow-independent signals and oxygen saturation. The impact of this new approach is that it may allow the design of more comfortable and reliable portable devices for screening, diagnosis and monitoring of OSA, functioning only with oximetry and airflow-independent (abdominal or chest) breathing sensors.

Rationale. The sleep-related factors that modulate the nocturnal worsening of asthma in children are poorly understood. This study addressed the hypothesis that asthmatic children have a REM sleep-related vulnerability trait that is independent of OSA.Methods. We conducted a retrospective cross-sectional analysis of pulse-oximetry signals obtained during REM and NREM sleep in control and asthmatic children (n=134). Asthma classification was based on preestablished clinical criteria. Multivariate linear regression model was built to control for potential confounders (significance levelP≤0.05).Results. Our data demonstrated that (1) baseline nocturnal respiratory parameters were not significantly different in asthmatic versus control children, (2) the maximal % of SaO2desaturation during REM, but not during NREM, was significantly higher in asthmatic children, and (3) multivariate analysis revealed that the association between asthma and REM-related maximal % SaO2desaturation was independent of demographic variables.Conclusion. These results demonstrate that children with asthma have a REM-related vulnerability trait that impacts oxygenation independently of OSA. Further research is needed to delineate the REM sleep neurobiological mechanisms that modulate the phenotypical expression of nocturnal asthma in children.

Background. Obese adolescents with Obstructive Sleep Apnea (OSA) have a unique pathophysiology that combines adenotonsillar hypertrophy and increased visceral fat distribution. We hypothesized that in this population waist circumference (WC), as a clinical marker of abdominal fat distribution, correlates with the likelihood of response to AT. Methods. We conducted a retrospective cohort study of obese adolescents (BMI ≥ 97th percentile) that underwent AT for therapy of severe OSA (n = 21). We contrasted WC and covariates in a group of subjects that had complete resolution of severe OSA after AT (n = 7) with those obtained in subjects with residual OSA after AT (n = 14). Multivariate linear and logistic models were built to control possible confounders. Results. WC correlated negatively with a positive AT response in young adolescents and the percentage of improvement in obstructive apnea-hypopnea index (OAHI) after AT (P ≤ 0.01). Extended multivariate analysis demonstrated that the link between WC and AT response was independent of demographic variables, OSA severity, clinical upper airway assessment, obesity severity (BMI), and neck circumference (NC). Conclusion. The results suggest that in obese adolescents, abdominal fat distribution determined by WC may be a useful clinical predictor for residual OSA after AT.