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Volume 59
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Article

Alterations in Inflammatory Markers and Cognitive Ability after Treatment of Pediatric Obstructive Sleep Apnea

by
Mohamed Shams Eldin
1,*,
Mohamed Alahmer
1,
Ebrahim Alkashlan
2,
Mahmoud Zahran
2,
Mohamed Eltonsy
3,
Amr Zewail
4,
Abdelfattah Kasem
5,
Khaled Abdelaal
6,*,
Mahrous Seddeek
7 and
Zakaria Ahmed
7
1
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Cairo 11675, Egypt
2
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo 11675, Egypt
3
Department of Clinical Pathology, Faculty of Medicine-Assiut, Al-Azhar University, Assiut 71542, Egypt
4
Department of Anatomy and Embryology-Basic Sciences, Vision Medical College, Jeddah 7327, Saudi Arabia
5
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo 11675, Egypt
6
EPCRS Excellence Center, Plant Pathology and Biotechnology Laboratory, Faculty of Agriculture, Kafrelsheikh University, Kafrelsheikh 33516, Egypt
7
Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo 11675, Egypt
*
Authors to whom correspondence should be addressed.
Medicina 2023, 59(2), 204; https://doi.org/10.3390/medicina59020204
Submission received: 4 December 2022 / Revised: 11 January 2023 / Accepted: 16 January 2023 / Published: 19 January 2023
(This article belongs to the Special Issue Obstructive Sleep Apnea: Epidemiology, Pathophysiology, and Management)
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Abstract

Background and Objectives: Determination of the impact of obstructive sleep apnea (OSA) on the cognitive function (CF), and serum tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and 1β levels and the effect of OSA management on these variables in children. Materials and Methods: A total of 224 patients were evaluated using the Pediatric Sleep Questionnaire, the NEPSY score for CF, and polysomnography (PSG) to grade OSA severity according to the apnea/hypopnea index (AHI). Adentonsillectomy (AT) was performed for patients with adenotonsillar hypertrophy grade > 2. Patients with overweight or obesity with mild or moderate OSAS underwent a 6-month protocol of lifestyle intervention (LSI). Blood samples were obtained for an enzyme-linked immunosorbent assay (ELISA) estimation of cytokine levels. All variables were re-evaluated at the end of the 6-month follow-up period. Results: A total of 181 patients had surgical interference and 43 patients underwent a LSI trial; 15 patients failed to respond and underwent surgery. At the end of the follow-up, 33 patients had residual OSAS with a significantly higher incidence among patients with severe OSAS, the mean score of the pediatric sleep questionnaire was significantly decreased in all patients, 181 patients showed an improved NESPY score, and cytokine levels were decreased. The baseline NESPY score, AHI index and sleep questionnaire score were negatively correlated. The percentage of change in the NESPY score and serum cytokine levels showed a positive correlation. Conclusions: OSAS is associated with cognitive dysfunction that significantly improves after adenotonsillectomy. LSI as a therapeutic line is satisfactory for children with mild OSAS and minimal cognitive dysfunction and is of value preoperatively to improve the surgical outcomes of AT.
Keywords: obstructive sleep apnea; cognitive function; inflammatory cytokines; adenotonsillectomy; lifestyle intervention obstructive sleep apnea; cognitive function; inflammatory cytokines; adenotonsillectomy; lifestyle intervention

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MDPI and ACS Style

Eldin, M.S.; Alahmer, M.; Alkashlan, E.; Zahran, M.; Eltonsy, M.; Zewail, A.; Kasem, A.; Abdelaal, K.; Seddeek, M.; Ahmed, Z. Alterations in Inflammatory Markers and Cognitive Ability after Treatment of Pediatric Obstructive Sleep Apnea. Medicina 2023, 59, 204. https://doi.org/10.3390/medicina59020204

AMA Style

Eldin MS, Alahmer M, Alkashlan E, Zahran M, Eltonsy M, Zewail A, Kasem A, Abdelaal K, Seddeek M, Ahmed Z. Alterations in Inflammatory Markers and Cognitive Ability after Treatment of Pediatric Obstructive Sleep Apnea. Medicina. 2023; 59(2):204. https://doi.org/10.3390/medicina59020204

Chicago/Turabian Style

Eldin, Mohamed Shams, Mohamed Alahmer, Ebrahim Alkashlan, Mahmoud Zahran, Mohamed Eltonsy, Amr Zewail, Abdelfattah Kasem, Khaled Abdelaal, Mahrous Seddeek, and Zakaria Ahmed. 2023. "Alterations in Inflammatory Markers and Cognitive Ability after Treatment of Pediatric Obstructive Sleep Apnea" Medicina 59, no. 2: 204. https://doi.org/10.3390/medicina59020204

APA Style

Eldin, M. S., Alahmer, M., Alkashlan, E., Zahran, M., Eltonsy, M., Zewail, A., Kasem, A., Abdelaal, K., Seddeek, M., & Ahmed, Z. (2023). Alterations in Inflammatory Markers and Cognitive Ability after Treatment of Pediatric Obstructive Sleep Apnea. Medicina, 59(2), 204. https://doi.org/10.3390/medicina59020204

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