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A four year follow-up of sleep and respiratory measures in elementary school-aged children with sleep disordered breathing.
Sleep Med. 2013 May; 14(5):440-8.SM

Abstract

OBJECTIVE

Little is known of the long-term prognosis of children treated for sleep disordered breathing (SDB) and even less of children with milder forms of SDB who remain untreated. We aimed to investigate the long-term sleep and respiratory outcomes of children with a range of SDB severities.

METHODS

41 children with SDB and 20 non snoring controls (mean age, 12.9±0.2 y), underwent repeat overnight polysomnography (PSG) 4.0±0.3years after initial diagnosis. SDB severity, presence of snoring, sleep and respiratory parameters, sleep fragmentation index (SFI), the Pediatric Daytime Sleepiness Scale (PDSS), Sleep Disturbance Scale for Children (SDSC), and obstructive sleep apnea 18-item quality of life questionnaire were re assessed. Children with SDB were grouped into resolved (no snoring and obstructive apnea-hypopnea index [OAHI] <1) and unresolved (snoring or an OAHI > or =1).

RESULTS

At follow-up OAHI was reduced in both SDB groups (p<0.05); however, 54% (n=22) of children still continued to snore, having either persistent or new OSA (n=4). In this unresolved group, sleep was significantly disrupted; % nonrapid eye movement stage 1 (NREM1) sleep and SFI were increased (p<0.05), and total sleep time (TST) and sleep efficiency were decreased compared to the resolved and control groups (p<0.05). Overall, 29% of children were treated, and of these, 67% had resolved SDB. SDB groups had higher PDSS, SDSC, and OSA-18 scores compared to controls at follow-up (p<0.01).

CONCLUSIONS

Our study demonstrated that although SDB improved in the long-term, more than 50% of children had residual SDB (mostly primary snoring) and sleep disturbance. As even mild forms of SDB are known to have adverse cardiovascular, learning, and behavioral outcomes, which have implications for the health of these children.

Authors+Show Affiliations

The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23499429

Citation

Vlahandonis, Anna, et al. "A Four Year Follow-up of Sleep and Respiratory Measures in Elementary School-aged Children With Sleep Disordered Breathing." Sleep Medicine, vol. 14, no. 5, 2013, pp. 440-8.
Vlahandonis A, Nixon GM, Davey MJ, et al. A four year follow-up of sleep and respiratory measures in elementary school-aged children with sleep disordered breathing. Sleep Med. 2013;14(5):440-8.
Vlahandonis, A., Nixon, G. M., Davey, M. J., Walter, L. M., & Horne, R. S. (2013). A four year follow-up of sleep and respiratory measures in elementary school-aged children with sleep disordered breathing. Sleep Medicine, 14(5), 440-8. https://doi.org/10.1016/j.sleep.2013.01.008
Vlahandonis A, et al. A Four Year Follow-up of Sleep and Respiratory Measures in Elementary School-aged Children With Sleep Disordered Breathing. Sleep Med. 2013;14(5):440-8. PubMed PMID: 23499429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A four year follow-up of sleep and respiratory measures in elementary school-aged children with sleep disordered breathing. AU - Vlahandonis,Anna, AU - Nixon,Gillian M, AU - Davey,Margot J, AU - Walter,Lisa M, AU - Horne,Rosemary S C, Y1 - 2013/03/15/ PY - 2012/10/26/received PY - 2013/01/18/revised PY - 2013/01/20/accepted PY - 2013/3/19/entrez PY - 2013/3/19/pubmed PY - 2013/12/18/medline SP - 440 EP - 8 JF - Sleep medicine JO - Sleep Med VL - 14 IS - 5 N2 - OBJECTIVE: Little is known of the long-term prognosis of children treated for sleep disordered breathing (SDB) and even less of children with milder forms of SDB who remain untreated. We aimed to investigate the long-term sleep and respiratory outcomes of children with a range of SDB severities. METHODS: 41 children with SDB and 20 non snoring controls (mean age, 12.9±0.2 y), underwent repeat overnight polysomnography (PSG) 4.0±0.3years after initial diagnosis. SDB severity, presence of snoring, sleep and respiratory parameters, sleep fragmentation index (SFI), the Pediatric Daytime Sleepiness Scale (PDSS), Sleep Disturbance Scale for Children (SDSC), and obstructive sleep apnea 18-item quality of life questionnaire were re assessed. Children with SDB were grouped into resolved (no snoring and obstructive apnea-hypopnea index [OAHI] <1) and unresolved (snoring or an OAHI > or =1). RESULTS: At follow-up OAHI was reduced in both SDB groups (p<0.05); however, 54% (n=22) of children still continued to snore, having either persistent or new OSA (n=4). In this unresolved group, sleep was significantly disrupted; % nonrapid eye movement stage 1 (NREM1) sleep and SFI were increased (p<0.05), and total sleep time (TST) and sleep efficiency were decreased compared to the resolved and control groups (p<0.05). Overall, 29% of children were treated, and of these, 67% had resolved SDB. SDB groups had higher PDSS, SDSC, and OSA-18 scores compared to controls at follow-up (p<0.01). CONCLUSIONS: Our study demonstrated that although SDB improved in the long-term, more than 50% of children had residual SDB (mostly primary snoring) and sleep disturbance. As even mild forms of SDB are known to have adverse cardiovascular, learning, and behavioral outcomes, which have implications for the health of these children. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/23499429/A_four_year_follow_up_of_sleep_and_respiratory_measures_in_elementary_school_aged_children_with_sleep_disordered_breathing_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(13)00039-7 DB - PRIME DP - Unbound Medicine ER -