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Inflammation and sleep disordered breathing in children: a state-of-the-art review.
Pediatr Pulmonol. 2008 Dec; 43(12):1151-60.PP

Abstract

Sleep disordered breathing (SDB) represents a spectrum of breathing disorders, ranging from snoring to obstructive sleep apnea syndrome (OSAS), that disrupt nocturnal respiration and sleep architecture. OSAS is a common disorder in children, with a prevalence of 2-3%. It is associated with neurobehavioral, cognitive, and cardiovascular morbidities. In children, adenotonsillectomy is the first choice for treatment and is reserved for moderate to severe OSAS, as defined by an overnight polysomnography. In adults, OSAS is the result of mechanical dysfunction of the upper airway, manifesting as severity-dependent nasal, oropharyngeal, and systemic inflammation that decrease after continuous positive airway pressure therapy. Inflammatory changes have been reported in upper airway samples from children with OSAS, and systemic inflammation, as indicated by high-sensitivity C-reactive protein (hsCRP) levels, has been shown to decrease in children with OSAS after adenotonsillectomy. Anti-inflammatory treatments for children with mild OSAS are associated with major improvements in symptoms, polysomnographic respiratory values, and radiologic measures of adenoid size. Inflammation is correlated to some extent with OSAS-related neurocognitive morbidity, but the role of inflammatory markers in the diagnosis and management of OSAS, and the role of anti-inflammatory treatments, remains to be clarified. This review examines the role of inflammation in the pathophysiology of sleep-disordered breathing in pediatric patients and the potential therapeutic implications.

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Authors+Show Affiliations

Goldbart AD
Department of Pediatrics, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. avivgold@bgu.ac.il
Tal A
No affiliation info available

MeSH

AnimalsAnti-Inflammatory AgentsC-Reactive ProteinChildHumansInflammationSeverity of Illness IndexSleep Apnea, Obstructive

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19009600

Clinical Trial Links

Inflammatory Markers in Infants With Obstructive Sleep Apnea

Citation

Goldbart, Aviv D., and Asher Tal. "Inflammation and Sleep Disordered Breathing in Children: a State-of-the-art Review." Pediatric Pulmonology, vol. 43, no. 12, 2008, pp. 1151-60.
Goldbart AD, Tal A. Inflammation and sleep disordered breathing in children: a state-of-the-art review. Pediatr Pulmonol. 2008;43(12):1151-60.
Goldbart, A. D., & Tal, A. (2008). Inflammation and sleep disordered breathing in children: a state-of-the-art review. Pediatric Pulmonology, 43(12), 1151-60. https://doi.org/10.1002/ppul.20943
Goldbart AD, Tal A. Inflammation and Sleep Disordered Breathing in Children: a State-of-the-art Review. Pediatr Pulmonol. 2008;43(12):1151-60. PubMed PMID: 19009600.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inflammation and sleep disordered breathing in children: a state-of-the-art review. AU - Goldbart,Aviv D, AU - Tal,Asher, PY - 2008/11/15/pubmed PY - 2009/4/25/medline PY - 2008/11/15/entrez SP - 1151 EP - 60 JF - Pediatric pulmonology JO - Pediatr Pulmonol VL - 43 IS - 12 N2 - Sleep disordered breathing (SDB) represents a spectrum of breathing disorders, ranging from snoring to obstructive sleep apnea syndrome (OSAS), that disrupt nocturnal respiration and sleep architecture. OSAS is a common disorder in children, with a prevalence of 2-3%. It is associated with neurobehavioral, cognitive, and cardiovascular morbidities. In children, adenotonsillectomy is the first choice for treatment and is reserved for moderate to severe OSAS, as defined by an overnight polysomnography. In adults, OSAS is the result of mechanical dysfunction of the upper airway, manifesting as severity-dependent nasal, oropharyngeal, and systemic inflammation that decrease after continuous positive airway pressure therapy. Inflammatory changes have been reported in upper airway samples from children with OSAS, and systemic inflammation, as indicated by high-sensitivity C-reactive protein (hsCRP) levels, has been shown to decrease in children with OSAS after adenotonsillectomy. Anti-inflammatory treatments for children with mild OSAS are associated with major improvements in symptoms, polysomnographic respiratory values, and radiologic measures of adenoid size. Inflammation is correlated to some extent with OSAS-related neurocognitive morbidity, but the role of inflammatory markers in the diagnosis and management of OSAS, and the role of anti-inflammatory treatments, remains to be clarified. This review examines the role of inflammation in the pathophysiology of sleep-disordered breathing in pediatric patients and the potential therapeutic implications. SN - 1099-0496 UR - https://www.unboundmedicine.com/medline/citation/19009600/Inflammation_and_sleep_disordered_breathing_in_children:_a_state_of_the_art_review_ L2 - https://doi.org/10.1002/ppul.20943 DB - PRIME DP - Unbound Medicine ER -