OBJECTIVE: The goal was to determine whether amelioration of sleep-disordered breathing through adenotonsillectomy would reduce middle cerebral artery velocity in parallel with improvements in cognition and behavior. METHODS: For 19 children (mean age: 6 years) with mild sleep-disordered breathing, and 14 healthy, ethnically similar and age-similar, control subjects, parents repeated the Pediatric Sleep Questionnaire an average of 12 months after adenotonsillectomy. Children with sleep-disordered breathing underwent repeated overnight measurement of mean oxyhemoglobin saturation. Neurobehavioral tests that yielded significant group differences preoperatively were readministered. Middle cerebral artery velocity measurements were repeated with blinding to sleep study and neuropsychological results, and mixed-design analyses of variance were performed. RESULTS: The median Pediatric Sleep Questionnaire score significantly improved postoperatively, and there was a significant increase in mean overnight oxyhemoglobin saturation. The middle cerebral artery velocity decreased in the sleep-disordered breathing group postoperatively, whereas control subjects showed a slight increase. A preoperative group difference was reduced by the postoperative assessment, which suggests normalization of middle cerebral artery velocity in those with sleep-disordered breathing. The increase in mean overnight oxyhemoglobin saturation postoperatively was associated with a reduction in middle cerebral artery velocity in a subgroup of children. A preoperative group difference in processing speed was reduced postoperatively. Similarly, a trend for a preoperative group difference in visual attention was reduced postoperatively. Executive function remained significantly worse for the children with sleep-disordered breathing, compared with control subjects, although mean postoperative scores were lower than preoperative scores. CONCLUSIONS: Otherwise-healthy young children with apparently mild sleep-disordered breathing have potentially reversible cerebral hemodynamic and neurobehavioral changes.
OBJECTIVE: The goal was to determine whether amelioration of sleep-disordered breathing through adenotonsillectomy would reduce middle cerebral artery velocity in parallel with improvements in cognition and behavior. METHODS: For 19 children (mean age: 6 years) with mild sleep-disordered breathing, and 14 healthy, ethnically similar and age-similar, control subjects, parents repeated the Pediatric Sleep Questionnaire an average of 12 months after adenotonsillectomy. Children with sleep-disordered breathing underwent repeated overnight measurement of mean oxyhemoglobin saturation. Neurobehavioral tests that yielded significant group differences preoperatively were readministered. Middle cerebral artery velocity measurements were repeated with blinding to sleep study and neuropsychological results, and mixed-design analyses of variance were performed. RESULTS: The median Pediatric Sleep Questionnaire score significantly improved postoperatively, and there was a significant increase in mean overnight oxyhemoglobin saturation. The middle cerebral artery velocity decreased in the sleep-disordered breathing group postoperatively, whereas control subjects showed a slight increase. A preoperative group difference was reduced by the postoperative assessment, which suggests normalization of middle cerebral artery velocity in those with sleep-disordered breathing. The increase in mean overnight oxyhemoglobin saturation postoperatively was associated with a reduction in middle cerebral artery velocity in a subgroup of children. A preoperative group difference in processing speed was reduced postoperatively. Similarly, a trend for a preoperative group difference in visual attention was reduced postoperatively. Executive function remained significantly worse for the children with sleep-disordered breathing, compared with control subjects, although mean postoperative scores were lower than preoperative scores. CONCLUSIONS: Otherwise-healthy young children with apparently mild sleep-disordered breathing have potentially reversible cerebral hemodynamic and neurobehavioral changes.
Authors: Seockhoon Chung; Elise K Hodges; Deborah L Ruzicka; Timothy F Hoban; Susan L Garetz; Kenneth E Guire; Barbara T Felt; James E Dillon; Ronald D Chervin; Bruno Giordani Journal: Int J Pediatr Otorhinolaryngol Date: 2015-11-10 Impact factor: 1.675
Authors: David R Busch; Jennifer M Lynch; Madeline E Winters; Ann L McCarthy; John J Newland; Tiffany Ko; Mary Anne Cornaglia; Jerilynn Radcliffe; Joseph M McDonough; John Samuel; Edward Matthews; Rui Xiao; Arjun G Yodh; Carole L Marcus; Daniel J Licht; Ignacio E Tapia Journal: Sleep Date: 2016-01-01 Impact factor: 5.849
Authors: Sarah N Biggs; Anna Vlahandonis; Vicki Anderson; Robert Bourke; Gillian M Nixon; Margot J Davey; Rosemary S C Horne Journal: Sleep Date: 2014-01-01 Impact factor: 5.849
Authors: Jo Howard; April E Slee; Simon Skene; Baba Inusa; Jamie Kawadler; Michelle Downes; Johanna Gavlak; Melanie Koelbel; Hanne Stotesbury; Maria Chorozoglou; Susan Tebbs; Subarna Chakravorty; Moji Awogbade; David C Rees; Atul Gupta; Patrick B Murphy; Nicholas Hart; Sati Sahota; Carol Nwosu; Maureen Gwam; Dawn Saunders; Vivek Muthurangu; Nathaniel Barber; Emmanuel Ako; Swee Lay Thein; Melanie Marshall; Isabel C Reading; Man Ying Edith Cheng; Fenella J Kirkham; Christina Liossi Journal: Trials Date: 2018-01-22 Impact factor: 2.279