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Cheung EC, Nilsson A, Venter I, Kowalik G, Ribeiro C, Rodriguez J, Kuraoka K, Russo R, Escobar JB, Alber BR, Mendelowitz D, Kay MW, Schunke KJ. Sex differences in cardiac transcriptomic response to neonatal sleep apnea. Physiol Rep 2024; 12:e16110. [PMID: 38981849 PMCID: PMC11233197 DOI: 10.14814/phy2.16110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/03/2024] [Accepted: 05/31/2024] [Indexed: 07/11/2024] Open
Abstract
Pediatric obstructive sleep apnea poses a significant health risk, with potential long-term consequences on cardiovascular health. This study explores the dichotomous nature of neonatal cardiac response to chronic intermittent hypoxia (CIH) between males and females, aiming to fill a critical knowledge gap in the understanding of sex-specific cardiovascular consequences of sleep apnea in early life. Neonates were exposed to CIH until p28 and underwent comprehensive in vivo physiological assessments, including whole-body plethysmography, treadmill stress-tests, and echocardiography. Results indicated that male CIH rats weighed 13.7% less than age-matched control males (p = 0.0365), while females exhibited a mild yet significant increased respiratory drive during sleep (93.94 ± 0.84 vs. 95.31 ± 0.81;p = 0.02). Transcriptomic analysis of left ventricular tissue revealed a substantial sex-based difference in the cardiac response to CIH, with males demonstrating a more pronounced alteration in gene expression compared to females (5986 vs. 3174 genes). The dysregulated miRNAs in males target metabolic genes, potentially predisposing the heart to altered metabolism and substrate utilization. Furthermore, CIH in males was associated with thinner left ventricular walls and dysregulation of genes involved in the cardiac action potential, possibly predisposing males to CIH-related arrhythmia. These findings emphasize the importance of considering sex-specific responses in understanding the cardiovascular implications of pediatric sleep apnea.
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Affiliation(s)
- Emily C. Cheung
- Department of Biomedical EngineeringThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
- Department of Pharmacology and PhysiologyThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Anna Nilsson
- Department of Anatomy, Biochemistry & PhysiologyUniversity of HawaiiHonoluluHawaiiUSA
| | - Ian Venter
- Department of Anatomy, Biochemistry & PhysiologyUniversity of HawaiiHonoluluHawaiiUSA
| | - Grant Kowalik
- Department of Biomedical EngineeringThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Caitlin Ribeiro
- Department of Pharmacology and PhysiologyThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Jeannette Rodriguez
- Department of Biomedical EngineeringThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Kiralee Kuraoka
- Department of Anatomy, Biochemistry & PhysiologyUniversity of HawaiiHonoluluHawaiiUSA
| | - Rebekah Russo
- Department of Biomedical EngineeringThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Joan B. Escobar
- Department of Pharmacology and PhysiologyThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Bridget R. Alber
- Department of Biomedical EngineeringThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - David Mendelowitz
- Department of Pharmacology and PhysiologyThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Matthew W. Kay
- Department of Biomedical EngineeringThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Kathryn J. Schunke
- Department of Biomedical EngineeringThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
- Department of Anatomy, Biochemistry & PhysiologyUniversity of HawaiiHonoluluHawaiiUSA
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Diéguez-Pérez M, Burgueño-Torres L, Reichard-Monefeldt G, Tapia-Sierra FE, Ticona-Flores JM. Prevalence and Characteristics of Sleep Disorders in Children Aged 7-17: Insights from Parental Observations at the Dental Office. CHILDREN (BASEL, SWITZERLAND) 2024; 11:609. [PMID: 38790604 PMCID: PMC11119357 DOI: 10.3390/children11050609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024]
Abstract
Sleep disorders (SD) in children is a topic of great relevance due to their impact on a child's general health. This has led us to study their prevalence and the factors that disturb them in the developing population. Using a validated Likert-type questionnaire, different behaviors observed by the parents during the different phases of their children's sleep were evaluated during the last 6 months. A total of 206 children between the ages of 7 and 17 who attended a dental office participated in the study. The prevalence of SD was 47.6%. There were no significant differences regarding the SD in relation to sex (p = 0.796). The mean total score for children aged 7 to 11 years old was 42.3 (±14.25) compared to 45.44 (±15.51) for the group consisting of children aged 12 to 17 years old, reporting a statistically significant difference among both age groups (p = 0.01). The most frequent disorder was related to initiating and maintaining sleep (64.9%) while the least prevalent were the respiratory sleep disorders (27.2%). Given the high prevalence of these disorders, it is necessary to intercept them during childhood and establish educational guidelines in this regard throughout primary care.
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Affiliation(s)
- Montserrat Diéguez-Pérez
- Department of Preclinical Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (G.R.-M.); (J.M.T.-F.)
| | - Laura Burgueño-Torres
- Dental Clinical Specialties Department, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (L.B.-T.); (F.E.T.-S.)
| | - Guillermo Reichard-Monefeldt
- Department of Preclinical Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (G.R.-M.); (J.M.T.-F.)
| | - Fanny Esther Tapia-Sierra
- Dental Clinical Specialties Department, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (L.B.-T.); (F.E.T.-S.)
| | - Jesús Miguel Ticona-Flores
- Department of Preclinical Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (G.R.-M.); (J.M.T.-F.)
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Alessandri-Bonetti A, Guglielmi F, Deledda G, Sangalli L, Brogna C, Gallenzi P. Malocclusions, Sleep Bruxism, and Obstructive Sleep Apnea Risk in Pediatric ADHD Patients: A Prospective Study. J Atten Disord 2024; 28:1017-1023. [PMID: 38327066 DOI: 10.1177/10870547231226139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Literature presents conflicting results regarding malocclusions, Obstructive Sleep Apnea (OSA) and sleep bruxism in children with ADHD. Aim of this study was to evaluate the prevalence of these parameters. METHODS A prospective study was conducted on 40 consecutive ADHD children referred to the Paediatric Dentistry Unit of Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome. All subjects underwent an orthodontic examination and were screened for OSA and sleep bruxism. Data were compared to a sex- and aged-matched control group. RESULTS Prevalence of high risk of OSA in children with ADHD was 62.5% compared to 10% in the control group (p < .00001). No differences were found in any of the occlusal variables examined between children with ADHD and controls (p > .05). An increased prevalence of sleep bruxism was observed in ADHD children (40%) compared to controls (7.5%) (p < .001). CONCLUSIONS A higher prevalence of OSA risk and probable sleep bruxism were observed in ADHD patients compared with controls. No significant differences were observed in malocclusions d.
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Affiliation(s)
| | | | - Giulia Deledda
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome
| | | | - Claudia Brogna
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome
| | - Patrizia Gallenzi
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome
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Kim CY, Reinertsen E, Dang C, Nkutshweu D, Sathekge R, Choi YJ, Cha JY, Alturki G, Jamel A, Suzuki A, Arai K, Amm E, Motro M, Parsi G. Association among craniofacial morphology, ethnicity, and risk of pediatric sleep-related breathing disorders: A multicenter study. Am J Orthod Dentofacial Orthop 2024; 165:414-422. [PMID: 38149956 DOI: 10.1016/j.ajodo.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Craniofacial morphology and ethnicity may be risk factors for sleep-related breathing disorder (SRBD) in children but have not yet been assessed in an international multicenter study. The objectives of this study were to assess the association among craniofacial features, self-reported ethnicity, and risk of SRBD in children undergoing orthodontic treatment. METHODS Children aged 5-18 years who presented for orthodontic evaluation were enrolled in the United States, South Africa, South Korea, Saudi Arabia, and Japan. The risk of SRBD was defined as answering ≥0.33 positive responses to the Pediatric Sleep Questionnaire. Craniofacial features included measurements in sagittal and vertical dimensions to evaluate the cranial base, maxillomandibular and dental relationships, and nasopharyngeal airway dimensions. Logistic regression was performed to assess the association among craniofacial features, ethnicity, age, body mass index, and risk of SRBD. RESULTS Data were obtained from 602 patients from 5 sites. A total of 76 patients (12.6%) had a risk of SRBD. The mean age was 12.5 years. Male gender (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.0-3.4; P = 0.041), Middle Eastern ethnicity (OR, 10.2; 95% CI, 4.1-25.4; P = 0.001), body mass index (OR, 1.1; 95% CI, 1.04-1.10; P = 0.001), gonial angle (OR, 0.91; 95% CI, 0.85-0.98; P = 0.011), and inferiorly positioned hyoid (OR, 1.1; 95% CI, 1.0-1.2; P = 0.002) were significantly associated with the risk of SRBD. CONCLUSIONS In an ambidirectional cohort study across 5 sites, male gender, Middle Eastern ethnicity, body mass index, gonial angle, and inferiorly positioned hyoid were associated with the risk of SRBD in children undergoing orthodontic treatment.
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Affiliation(s)
- Chai Yoon Kim
- Department of Orthodontics and Dentofacial Orthopedics, Boston University Henry M Goldman School of Dental Medicine, Boston, Mass
| | - Erik Reinertsen
- Research Laboratory of Electronics, MIT, Massachusetts Institute of Technology, Cambridge, Mass
| | - Calvin Dang
- Department of Orthodontics and Dentofacial Orthopedics, Boston University Henry M Goldman School of Dental Medicine, Boston, Mass
| | - Dineo Nkutshweu
- Department of Orthodontics, 1 Military Hospital, Pretoria, South Africa
| | - Rachel Sathekge
- Department of Orthodontics, 1 Military Hospital, Pretoria, South Africa
| | - Yoon Jeong Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ghassan Alturki
- Department of Orthodontics, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Ahmad Jamel
- Department of Orthodontics, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Akihiro Suzuki
- Department of Orthodontics, School of Life Dentistry, The Nippon Dental University, Tokyo, Japan
| | - Kazuhito Arai
- Department of Orthodontics, School of Life Dentistry, The Nippon Dental University, Tokyo, Japan
| | - Elie Amm
- Department of Orthodontics and Dentofacial Orthopedics, Boston University Henry M Goldman School of Dental Medicine, Boston, Mass
| | - Melih Motro
- Department of Orthodontics and Dentofacial Orthopedics, Boston University Henry M Goldman School of Dental Medicine, Boston, Mass
| | - Goli Parsi
- Department of Orthodontics and Dentofacial Orthopedics, Boston University Henry M Goldman School of Dental Medicine, Boston, Mass.
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Staderini E, Chiusolo G, Guglielmi F, Papi M, Perini G, Tepedino M, Gallenzi P. Effects of Thermoforming on the Mechanical, Optical, Chemical, and Morphological Properties of PET-G: In Vitro Study. Polymers (Basel) 2024; 16:203. [PMID: 38257002 PMCID: PMC10820839 DOI: 10.3390/polym16020203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/30/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
The effectiveness of clear aligners in correcting malocclusions is closely linked to the properties of the materials used to make them. The polymers used in the manufacture of clear aligners have well-established properties. However, the process of manufacturing clear aligners, known as thermoforming, involves thermal and mechanical shocks that may alter these properties. The objective of this study was to evaluate the effects of thermoforming on the mechanical, optical, chemical, and morphological properties of sixty PET-G specimens. The study compared the thickness, weight, absorbance, chemical structure, surface roughness, elastic modulus, yield strength, and breaking load of thirty thermoformed specimens with thirty non-thermoformed specimens. The study introduces a new approach by using standardized samples to analyze both chemical and physical properties. The results showed statistically significant differences in thickness (-15%), weight (-11%), and surface roughness (+1233% in roughness average; +1129% in RMS roughness) of the material. Additionally, a correlation was found between reduction in thickness and increase in opalescence. There was no significant change in the functionality of the aligners after thermoforming, as no significant mechanical changes were found. However, the increase in surface roughness may lead to plaque and fluid accumulation and worsen the fit of the aligners.
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Affiliation(s)
- Edoardo Staderini
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
- Postgraduate School of Orthodontics–Director: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giuseppe Chiusolo
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
| | - Federica Guglielmi
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
- Postgraduate School of Orthodontics–Director: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Massimiliano Papi
- Department of Neurosciences, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy; (M.P.); (G.P.)
- IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giordano Perini
- Department of Neurosciences, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy; (M.P.); (G.P.)
- IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Piazza Santa Margherita 2, 67100 L’Aquila, Italy
| | - Patrizia Gallenzi
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
- Postgraduate School of Orthodontics–Director: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy
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Gunnett M, Rocque BG, Nourani A, Beltran-Ale G. Impact of Spina Bifida on Sleep Quality: Current Insights. Nat Sci Sleep 2023; 15:967-978. [PMID: 38034043 PMCID: PMC10685378 DOI: 10.2147/nss.s401269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
Spina bifida (SB) is one of the most common birth defects in children. The care for patients with SB continues to evolve, and there has been notable improvement in survival outcomes, degree of disability and quality of life for these children. However, patients with SB continue to remain at higher risk for sleep-related breathing disorders (SRBD), unexplained sudden death, and potential alterations in their sleep chronotype. Previous studies report on abnormalities in the spinal cord, brainstem function, and dysfunction of upper airway maintenance as the likely mechanisms behind SRBD that is commonly seen in SB. Most studies looking at prevalence of SRBD in SB have been retrospective studies. A recent prospective study identified a prevalence as high as 42% when a polysomnography (PSG) was completed on all patients regardless of symptomatology. Treatment options vary depending on the type and severity of SRBD and can range widely. Despite advances in care for patients with SB and SRBD, a subset of these patients with myelomeningocele (MMC) continue to experience sudden unexplained death. Studies continue to evaluate ways to stratify which of these patients may be at higher risk of this devastating outcome. Given that SRBD is potentially treatable, early assessment and intervention could become an integral part of a multidisciplinary treatment strategy to optimize long-term medical and neurodevelopmental outcomes for this patient population. By understanding the impact that SB may have on a patient's sleep quality, their biological chronotype and their potential of developing SRBD, a provider may help to optimize the care a patient with SB receives from birth into adulthood.
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Affiliation(s)
- Mohini Gunnett
- Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Brandon G Rocque
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Anis Nourani
- Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Guillermo Beltran-Ale
- Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
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Benbir Senel G, Aktan Suzgun M, Bibinoglu Amirov C, Karadeniz D. The Comparison of the Sleep Structure and Sleep Spindle Activity in Children With Primary Snoring and Sleep-Disordered Breathing. Clin Pediatr (Phila) 2023; 62:565-570. [PMID: 36433642 DOI: 10.1177/00099228221139985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Obstructive sleep apnea syndrome (OSAS) in children is associated with changes in the structure of sleep. The possible effects of snoring on spindle activity have not been established. We analyzed the polysomnography recordings and sleep spindle activity in children with primary snoring and/or OSAS compared with healthy children. Fifty-one children were included; 8 had primary snoring, 16 had OSAS and snoring, 11 had OSAS without snoring, and 16 were healthy controls. The density (P = .034) and duration (P = .019) of sleep spindles were decreased in children with OSAS compared with controls. The sleep spindle activity did not show significant changes between children with primary snoring and healthy controls, or between OSAS with/without snoring. We conclude that it is not snoring per se but OSAS that affects sleep spindle activity. Obstructive sleep apnea syndrome with/without snoring deserves greater attention because it has different phenotypes of the disease with different pathophysiologies.
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Affiliation(s)
- G Benbir Senel
- Department of Neurology, Sleep and Disorders Unit, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - M Aktan Suzgun
- Department of Neurology, Sleep and Disorders Unit, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - C Bibinoglu Amirov
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - D Karadeniz
- Department of Neurology, Sleep and Disorders Unit, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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8
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Wellham A, Kim C, Kwok SS, Lee R, Naoum S, Razza JM, Goonewardene MS. Sleep-disordered breathing in children seeking orthodontic care-an Australian perspective. Aust Dent J 2023; 68:26-34. [PMID: 36346173 DOI: 10.1111/adj.12945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The prevalence of sleep-disordered breathing in children is underestimated due to impediments in detection and diagnosis. Consequently, delayed management may affect the quality of life and the growth and development of a child. Due to their patient demographic, orthodontists are optimally positioned to identify those at risk of sleep-disordered breathing and make referrals for investigation and management. This study aims to determine the prevalence of children at risk of sleep-disordered breathing in an Australian orthodontic population. METHODS A 1-year retrospective study was conducted in an urban Western Australian private orthodontic practice with two branches in similar socioeconomic demographics. The responses of new patients to a modified paediatric sleep questionnaire and standard medical history form were recorded. RESULTS In 1209 patients (4-18 years), 7.3% were at risk of sleep-disordered breathing. An association between sex and the potential risk of sleep-disordered breathing was found with 11% of males at risk of sleep-disordered breathing compared to 7% of females (P = 0.012). CONCLUSIONS The relatively high prevalence of children at risk of sleep-disordered breathing presenting for orthodontic care presents an opportunity to identify at-risk individuals through routine use of the paediatric sleep questionnaire. This would facilitate early referral for diagnosis and management of sleep-disordered breathing.
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Affiliation(s)
- A Wellham
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - C Kim
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - S S Kwok
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Rjh Lee
- School of Dentistry, The University of Western Australia, Nedlands, Western Australia, Australia
| | - S Naoum
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - J M Razza
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - M S Goonewardene
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
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Luzzi V, DE Filippo M, Guarnieri R, Fioravanti M, Guaragna M, Marasca B, Pirro V, Altieri F, Vozza I, Ndokaj A, Brindisi G, Barbato E, Polimeni A, Zicari AM. Evaluation of nasal airway resistance in a cohort of children with primary snoring and maxillary deficiency. Minerva Dent Oral Sci 2023; 72:54-59. [PMID: 36345835 DOI: 10.23736/s2724-6329.22.04727-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of this study was to test whether rapid palatal expansion is effective to improve nasal airway patency in a sample of pediatric patients with primary snoring. METHODS A group of 21 subjects, 11 girls (52%) and 10 boys (48%), with a mean age of 7.1 years (SD=1.3; range 4-9 years) were treated with a rapid maxillary expansion (RME) device. Nasal airway resistance was assessed via rhinomanometric exam before (pre-) and 6 months after (post-) the rapid palatal expansion treatment. RESULTS Data analysis showed a statistically significant increase in the mean scores of the results of the rhinomanometric exam between the pre- and post-measurements with a significant reduction in total inspiratory and expiratory air resistance values after rapid palatal expansion. CONCLUSIONS Our results show that RME treatment is associated with an improvement in nasal airway resistance due to a substantial reduction in nasal resistance associated with the orthopedic action of the orthodontic device.
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Affiliation(s)
- Valeria Luzzi
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Maria DE Filippo
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
| | - Rosanna Guarnieri
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Miriam Fioravanti
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy -
| | - Mariana Guaragna
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Beatrice Marasca
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Valentina Pirro
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Federica Altieri
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Artnora Ndokaj
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
| | - Giulia Brindisi
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
| | - Ersilia Barbato
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Anna Maria Zicari
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
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10
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Sleep problems in low income, urban pediatric populations living at different altitudes in Colombia. Sleep Med 2022; 100:64-70. [PMID: 36027664 DOI: 10.1016/j.sleep.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To determine the frequency of sleep problems in low-income, urban pediatric populations in cities at different altitudes in Colombia. METHODS A descriptive, cross-sectional population-based observational study was conducted in children aged between 2 and 12 years in the low income, urban areas of three cities in Colombia (Santa Marta, Bucaramanga, and Bogotá) located at 15, 959, and 2640 m above sea level, respectively. Sociodemographic data were collected, and the Spanish version of the Pediatric Sleep Questionnaire was used. RESULTS 1989 children were surveyed, distributed as follows: Santa Marta (32.0%), Bucaramanga (33.4%), and Bogotá (34.6%). The overall prevalence of sleep problems was 39.0%. Children from Santa Marta had the highest frequency of parasomnias (58.0%); those from Bucaramanga had the highest frequency of attention deficit symptoms (4.0%) and apneic pauses witnessed by parents or caregivers (5.7%). Finally, Bogotá, the only high-altitude location, had the highest frequency of sleep disordered breathing (17.2%). CONCLUSIONS The study found a high frequency of sleep problems in the pediatric population, especially at higher altitudes when compared to lower altitude settings. Sleep disorders warrant early detection and timely therapeutic intervention.
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Blumer S, Eli I, Kaminsky-Kurtz S, Shreiber-Fridman Y, Dolev E, Emodi-Perlman A. Sleep-Related Breathing Disorders in Children—Red Flags in Pediatric Care. J Clin Med 2022; 11:jcm11195570. [PMID: 36233440 PMCID: PMC9573712 DOI: 10.3390/jcm11195570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: In recent years, we have witnessed a growing interest in pediatric sleep-related breathing disorders (SRBD). Although a Pediatric Sleep Questionnaire (PSQ) exists and was found reliable in screening SRBD in children, many of the children remain underdiagnosed. The aim of the present study was to define anamnestic and clinical findings that can serve as red flags indicating the presence of SRBD in children. Methods: 227 children aged 4–12 years old were evaluated with regard to the following parameters: (i) anamnestic variables (e.g., general state of health, oral habits, bruxism, esophageal reflux, sleep continuity, snoring); (ii) clinical parameters (e.g., oral mucosa, palate, tonsils, tongue, floor of the mouth, angle classification, gingival health, caries risk) and (iii) presence of SRBD (through the PSQ). Results: Significant differences between children with and without SRBD were observed regarding continuous sleep, developmental delay, mouth breathing, and snoring. Taking medications for ADHD increased the odds of SRBD in children by over seven times, non-continuous sleep increased the odds of SRBD by six times, mouth breathing increased the odds by almost five times, and snoring increased the odds by over three times. Conclusions: Child caregivers from various fields (dentists, orthodontists, pediatric physicians, school nurses) should actively inquire about disturbed sleep, medications for ADHD, snoring, and mouth breathing among their young patients. Initial screening through a few simple questions may help raise red flags that can assist in the early detection of SRBD in children and lead to proper diagnosis and treatment.
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Affiliation(s)
- Sigalit Blumer
- Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Ilana Eli
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Shani Kaminsky-Kurtz
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Yarden Shreiber-Fridman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Eran Dolev
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
- Correspondence:
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Inada E, Saitoh I, Kaihara Y, Murakami D, Nogami Y, Kiyokawa Y, Tanaka R, Sakata K, Yamasaki Y. Factors related to mouth breathing syndrome in preschool children and the effects of incompetent lip seal: An exploratory study. Clin Exp Dent Res 2022; 8:1555-1560. [PMID: 36106473 PMCID: PMC9760156 DOI: 10.1002/cre2.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/12/2022] [Accepted: 08/27/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES A set of orofacial signs and symptoms completely or partially present in individuals who replace the correct pattern of nasal breathing with an oral or mixed pattern is defined as mouth breathing syndrome (MBS). In a previous report, it was clarified that an incompetent lip seal (ILS) affected the occurrence of MBS among primary school children. However, the factors related to MBS and the effect of ILS in preschool children remain unclear. The purpose of this study was to clarify the factors relevant to MBS in preschool children and investigate the relationship of ILS to MBS. MATERIAL AND METHODS We surveyed 285 preschool children between 3 and 5 years of age. Their guardians completed the questionnaire, which consisted of 44 questions regarding the children's daily health conditions and lifestyle habits. To classify the closely related questions into their respective factors and to examine the strength of the correlation between the newly revealed factors, an exploratory factor analysis with promax rotation was performed. RESULTS The factor analysis identified nine items representing four factors. Factors 1-4 were defined as "diseases of the nose," "ILS," "problem with swallowing and chewing," and "eating and drinking habits," respectively. Factor 2 most strongly correlated with Factor 1, and both Factors showed a relatively strong correlation with Factor 3. CONCLUSIONS The initial stage of MBS may be present in preschool children. ILS and diseases of the nose can cause poor development of oral functions, such as breathing and eating.
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Affiliation(s)
- Emi Inada
- Department of Pediatric DentistryKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Issei Saitoh
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan
| | | | - Daisuke Murakami
- Department of Pediatric DentistryKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Yukiko Nogami
- Division of Pediatric Dentistry, Graduate School of Medical and Dental ScienceNiigata UniversityNiigataChuo‐kuJapan
| | - Yuki Kiyokawa
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan,Division of Pediatric Dentistry, Graduate School of Medical and Dental ScienceNiigata UniversityNiigataChuo‐kuJapan
| | - Reira Tanaka
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan
| | - Kensuke Sakata
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan
| | - Youichi Yamasaki
- Department of Pediatric DentistryKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
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Zaffanello M, Franchini M, Piacentini G. Pediatric Sleep-Disordered Breathing and Long-Term Complications: Clinical and Health Implications. J Clin Med 2022; 11:jcm11175178. [PMID: 36079107 PMCID: PMC9457297 DOI: 10.3390/jcm11175178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marco Zaffanello
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy
- Correspondence:
| | - Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantova, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy
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Eisenberg A, Hobart-Porter L, Jambhekar S, Ocal E, Stewart S, Thornton K, Tackett C. Sleep related breathing disorders in the spina bifida population ages 1-20 years: A retrospective study in Arkansas. J Pediatr Rehabil Med 2022; 15:581-586. [PMID: 36502346 DOI: 10.3233/prm-210129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Sleep related breathing disorders (SRBD) are seen at disproportionately higher rates in children with spina bifida compared with their same aged peers. SRBD such as obstructive sleep apnea (OSA) or central apnea are associated with developmental and cognitive consequences, and sudden death. METHODS Participants aged 1 to 20 years with a diagnosis of spina bifida were recruited from a pediatric academic hospital spinal cord specialty clinic to evaluate the prevalence and impact of sleep disorders in the spina bifida population; 76 polysomnogram (PSG) reports spanning a 3-year period were reviewed in this retrospective cohort study. RESULTS Of the PSGs reviewed, 37 (49%) indicated the presence of SRBD, and 28 (76%) of those children required an escalation of management (surgical intervention or additional respiratory support). These results are consistent with previous studies and further emphasize the clinical impact of SRBD on children with spina bifida by describing the interventions that followed an abnormal PSG. CONCLUSION The high prevalence of SRBD in the spina bifida population supports the need for additional research to develop sleep questionnaires specific to spina bifida that can predict abnormal PSG clinically and to determine the standard of care following an abnormal PSG, chiefly in OSA and central apnea.
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Affiliation(s)
- Amy Eisenberg
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Laura Hobart-Porter
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Supriya Jambhekar
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Pediatric Pulmonary & Sleep Medicine, Arkansas Children's Hospital Pediatrics Sleep Disorders Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eylem Ocal
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Scott Stewart
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Kariel Thornton
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Tech University, Russellville, AR, USA
| | - Caroline Tackett
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Hendrix College, Conway, AR, USA
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Yamada H, Sawada M, Higashino M, Abe S, El-Bialy T, Tanaka E. Longitudinal Morphological Changes in the Adenoids and Tonsils in Japanese School Children. J Clin Med 2021; 10:4956. [PMID: 34768477 PMCID: PMC8584668 DOI: 10.3390/jcm10214956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 11/18/2022] Open
Abstract
The adenoid (Ad) and tonsil (Ts), located in the upper airway, play an important role in immunological protection. These lymphoid tissues grow rapidly, reach a peak of growth at the age of 6-8 years, and decrease in their size thereafter. However, little information is available on the longitudinal growth patterns of Ad and Ts in the general population. This study aimed to evaluate the individual growth of Ad and Ts during childhood using lateral cephalograms taken longitudinally from the same individuals at the ages of 8-12 years. Our results showed that the cross-sectional areas of the Ad, nasopharynx (Np), and oropharynx (Op) significantly increased with age while small changes in the size of Ts were present throughout the study period. In addition, the values of Ad/Np and Ts/Op decreased significantly with age in the elementary school. Furthermore, there was a strong and significant correlation between the Ad/Np ratio and upper airway resistance, indicating the narrowest distance in the upper airway. In conclusion, the airway occupation in Np and Op increased with age due to the increase in the sizes of Np and Op but not the decrease in the sizes of Ad and Ts.
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Affiliation(s)
- Hiroshi Yamada
- Yamada Orthodontic Office, Izumiotsu, Osaka 595-0025, Japan; (H.Y.); (M.S.)
| | - Masaki Sawada
- Yamada Orthodontic Office, Izumiotsu, Osaka 595-0025, Japan; (H.Y.); (M.S.)
| | - Masaaki Higashino
- Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka 569-8686, Japan;
| | - Susumu Abe
- Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8504, Japan;
| | - Tarek El-Bialy
- Department of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8504, Japan
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Obstructing Sleep Apnea in Children with Genetic Disorders-A Special Need for Early Multidisciplinary Diagnosis and Treatment. J Clin Med 2021; 10:jcm10102156. [PMID: 34067548 PMCID: PMC8156845 DOI: 10.3390/jcm10102156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background—Children with genetic disorders have multiple anatomical and physiological conditions that predispose them to obstructive sleep apnea syndrome (OSAS). They should have priority access to polysomnography (PSG) before establishing their therapeutic protocol. We analyzed the prevalence and the severity of OSAS in a particular group of children with genetic disorders and strengthened their need for a multidisciplinary diagnosis and adapted management. Methods—The retrospective analysis included children with genetic impairments and sleep disturbances that were referred for polysomnography. We collected respiratory parameters from sleep studies: apnea–hypopnea index (AHI), SatO2 nadir, end-tidal CO2, and transcutaneous CO2. Subsequent management included non-invasive ventilation (NIV) or otorhinolaryngological (ENT) surgery of the upper airway. Results—We identified 108 patients with neuromuscular disorders or multiple congenital anomalies. OSAS was present in 87 patients (80.5%), 3 of whom received CPAP, 32 needed another form of NIV during sleep, and 15 patients were referred for ENT surgery. The post-therapeutic follow-up PSG parameters confirmed the success of the treatment. Conclusions—The upper airway obstruction diagnostics and management for children with complex genetic diseases need a multidisciplinary approach. Early detection and treatment of sleep-disordered breathing in children with genetic disorders is a priority for improving their quality of life.
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Oral Prevention and Management of Oral Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041970. [PMID: 33670604 PMCID: PMC7922105 DOI: 10.3390/ijerph18041970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 12/13/2022]
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