Pediatric Sleep-Disordered Breathing and Long-Term Complications: Clinical and Health Implications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 6650

Special Issue Editor


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Guest Editor
Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Faculty of Medicine, University of Verona, 37124 Verona, Italy
Interests: sleep-disordered breathing; sleep apnea syndrome; children; infants
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Special Issue Information

Dear Colleagues,

Sleep-disordered breathing is characterized by snoring and respiratory effort secondary to an increased resistance of the upper airways, with alteration of normal breathing, an intermittent reduction in oxygenation, and the disorganization of the sleep architecture. Sleep-disordered breathing are frequent in children with a peak in incidence during preschool and school age. Complications are borne by various organs and systems due to systemic inflammation. In particular, they affect the cardiovascular system, metabolism, body growth, and the neurocognitive–behavioral aspect. Complications are strongly associated with morbidity and morbidity. It is therefore necessary to intervene actively and early to treat sleep-disordered breathing. Breathing disorders in pediatric sleep, if not adequately treated, can have important negative health implications that are prolonged and worsen in adulthood.

This Special Issue aims to address the implications for pediatric and adult health, in all its aspects, with an eye to transitional medicine. We would be honored to have robust contributions from experts in order to update the scientific literature on this important and complex topic.

Dr. Marco Zaffanello
Guest Editor

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Keywords

  • adult
  • child
  • complication
  • health
  • obstructive sleep apnea syndrome
  • sleep-disordered breathing

Published Papers (4 papers)

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Editorial

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3 pages, 199 KiB  
Editorial
Pediatric Sleep-Disordered Breathing and Long-Term Complications: Clinical and Health Implications
by Marco Zaffanello, Massimo Franchini and Giorgio Piacentini
J. Clin. Med. 2022, 11(17), 5178; https://doi.org/10.3390/jcm11175178 - 1 Sep 2022
Cited by 2 | Viewed by 1177
Abstract
Transitional medicine is defined as the branch of medicine which deals with the transition from the pediatric to adult healthcare system [...] Full article

Research

Jump to: Editorial

13 pages, 1003 KiB  
Article
Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome: Clinical and Functional Outcomes
by Cristian Locci, Caterina Cenere, Giovanni Sotgiu, Mariangela Valentina Puci, Laura Saderi, Davide Rizzo, Francesco Bussu and Roberto Antonucci
J. Clin. Med. 2023, 12(18), 5826; https://doi.org/10.3390/jcm12185826 - 7 Sep 2023
Cited by 2 | Viewed by 1140
Abstract
Adenotonsillectomy (AT) is the first-line treatment for pediatric obstructive sleep apnea syndrome (OSAS). Relatively few studies have evaluated the clinical and functional outcomes of AT in children with OSAS, but these studies show that surgery improves behavior and quality of life (QOL). However, [...] Read more.
Adenotonsillectomy (AT) is the first-line treatment for pediatric obstructive sleep apnea syndrome (OSAS). Relatively few studies have evaluated the clinical and functional outcomes of AT in children with OSAS, but these studies show that surgery improves behavior and quality of life (QOL). However, residual OSAS after AT is reported in severe cases. This study aimed to retrospectively evaluate the clinical and functional outcomes of AT in a cohort of children with OSAS. We consecutively enrolled children with OSAS who underwent AT and were admitted to our clinic from 1 July 2020 to 31 December 2022. For each participant, medical history and physical examinations were performed. Before and after surgery, all patients underwent a standard polygraphic evaluation, and caregivers completed the OSA-18 questionnaire. A total of 65 children with OSAS, aged 2–9 years, were included. After AT, 64 (98.4%) children showed a reduction in AHI, with median (IQR) values decreasing from 13.4/h (8.3–18.5/h) to 2.4/h (1.8–3.1/h) (p-value < 0.0001). Conversely, median (IQR) SpO2 nadir increased after surgery from 89% (84–92%) to 94% (93–95%) (p-value < 0.0001). Moreover, 27 children (18%) showed residual OSAS. The OSA-18 score decreased after AT from median (IQR) values of 84 (76–91) to values of 33 (26–44) (p-value < 0.0001). A positive significant correlation was found between OSA-18 post-operative scores and AHI post-operative scores (rho 0.31; p-value = 0.01). Our findings indicate that, in children with OSAS, AT is associated with significant improvements in behavior, QOL, and polygraphic parameters. However, long-term post-surgical follow-up to monitor for residual OSAS is highly recommended, especially in more severe cases. Full article
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11 pages, 1513 KiB  
Article
Relationships between 25-Hydroxyvitamin D Levels and Obstructive Sleep Apnea Severity in Children: An Observational Study
by Cristian Locci, Antonella Ruiu, Laura Saderi, Giovanni Sotgiu, Stefania Bassu, Marco Zaffanello and Roberto Antonucci
J. Clin. Med. 2023, 12(3), 1242; https://doi.org/10.3390/jcm12031242 - 3 Feb 2023
Cited by 1 | Viewed by 1697
Abstract
The prevalence of hypovitaminosis D is increasing worldwide. Vitamin D deficiency is supposed to play a role in sleep disturbances, but the complex relationships between hypovitaminosis D and pediatric obstructive sleep apnea syndrome (OSAS) are still incompletely understood. This study was aimed to [...] Read more.
The prevalence of hypovitaminosis D is increasing worldwide. Vitamin D deficiency is supposed to play a role in sleep disturbances, but the complex relationships between hypovitaminosis D and pediatric obstructive sleep apnea syndrome (OSAS) are still incompletely understood. This study was aimed to retrospectively investigate the vitamin D status and significant clinical, laboratory, and instrumental variables in a cohort of pediatric patients with OSAS and to assess the possible relationship between serum vitamin D levels and OSAS severity. We consecutively enrolled all children aged 2–14 years admitted to our Pediatric Clinic from 1 July 2018 to 30 November 2020 for sleep-disordered breathing. Each patient underwent standard overnight in-hospital polygraphic evaluation, measurement of serum 25-hydroxyvitamin D (25(OH)D) levels, and clinical and laboratory investigation. A total of 127 children with OSAS were included. The 25(OH)D levels and BMI of OSAS patients were compared with those of an age-matched control group: the serum 25(OH)D levels were significantly lower in OSAS patients than in controls (22.4 vs. 25.5 ng/mL; p-value = 0.009), whereas no differences in the BMI percentile were found between the two groups. The mean value of 25(OH)D was not significantly lower (20.9 ng/mL) in the severe OSAS group compared with the mild (23.0 ng/mL) and moderate (23.3 ng/mL) OSAS groups (p-value = 0.28). Our findings indicate a relationship between vitamin D status and OSAS in children and suggest that severe cases of OSAS have lower vitamin D levels. Future, more extensive prospective studies are needed to confirm such preliminary findings. Full article
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10 pages, 273 KiB  
Article
Sleep-Related Breathing Disorders in Children—Red Flags in Pediatric Care
by Sigalit Blumer, Ilana Eli, Shani Kaminsky-Kurtz, Yarden Shreiber-Fridman, Eran Dolev and Alona Emodi-Perlman
J. Clin. Med. 2022, 11(19), 5570; https://doi.org/10.3390/jcm11195570 - 22 Sep 2022
Cited by 4 | Viewed by 1963
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 [...] Read more.
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. Full article
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