Surgical interventions for obstructive sleep apnea (OSA) are less effective in obese than in normal-weight children. However, the mechanisms that underpin this relationship are not fully understood. Therefore, this study aimed to explore how body weight influences upper airway collapse and treatment outcome in children with OSA.
We conducted a retrospective analysis of prospectively collected data on polysomnography, drug-induced sleep endoscopy (DISE), and treatment outcome in otherwise healthy children with OSA. Associations between body mass index (BMI) z-score and upper airway collapse during DISE were assessed using logistic regression modelling. Treatment success was defined as obstructive apnea-hypopnea index (oAHI)<5 events/hour and cure as oAHI<2 events/hour with obstructive apnea index<1 event/hour.
A total of 139 children were included [median (Q1─Q3); age 4.5 (3.1─8.4) years; BMI z-score 0.3 (-0.8 to 1.4); oAHI 10.8 (6.8─18.0) events/hour]. Twenty-five of them were overweight and 21 were obese. After adjusting for age and history of upper airway surgery, BMI z-score was significantly correlated with circumferential upper airway collapse during DISE (odds ratio 1.67; 95% confidence interval 1.12─2.65; P=0.011). Outcome of DISE-directed treatment was similar in normal-weight (success 91.4%; cure 78.5%), overweight (success 88.0%; cure 80.0%), and obese (success 90.5%; cure 76.5%) children. Children with circumferential collapse responded better to continuous positive airway pressure than to (adeno)tonsillectomy.
Increasing body weight is associated with circumferential upper airway collapse during DISE and, accordingly, may require treatment strategies other than (adeno)tonsillectomy.
Increasing body weight is associated with circumferential upper airway collapse during DISE and, accordingly, may require treatment strategies other than (adeno)tonsillectomy.
Sleep timing is related to several risk factors for angina pectoris (AP), such as obesity and diabetes. This study was designed to evaluate the relationship between sleep timing and AP, specifically whether later bedtime was associated with AP in middle-aged and older adults.
This community-based study was based on the Sleep Heart Health Study cohort and included 4710 participants (45.9% men, aged 63.3±11.0 years). Lifestyle and epidemiological information were obtained from baseline records. Self-reported sleep measures provided information on bedtime and wake-up time of weekdays and weekends. Individuals were divided into three categories according to bedtime (≤2200, 2201-2300, and >2300). Odds ratios (OR) and 95% confidence intervals (CIs) of AP for bedtimes were estimated with multivariate logistic regression analysis.
The prevalence of AP was 44.2% and the distribution of weekday bedtimes ≤2200, 2201-2300
and >2300 were 36.6%, 47.5% and 46.0%, respectively. After adjusting for potential confounders, weekday bedtimes >2300 (OR 1.34; 95% CI 1.13-1.60; P=0.001) and 2201-2300 (OR 1.54; 95% CI 1.29-1.82; P<0.001) were significantly associated with an increased risk of AP compared with the reference group (≤2200). In addition, weekend bedtimes >2300 (OR 1.44; 95% CI 1.20-1.73; P<0.001) and 2201-2300 (OR 1.70; 95% CI 1.40-2.05; P<0.001) increased the risk of AP.
Later bedtimes on both weekdays and weekends were significantly associated with an increased prevalence of AP. Early bedtimes may help people decrease the risk of AP.
Later bedtimes on both weekdays and weekends were significantly associated with an increased prevalence of AP. Early bedtimes may help people decrease the risk of AP.
There are numerous radiography and photogrammetry-based methods of assessing the cervical spine posture in the sagittal plane. The choice of instrument should be based on scientific parameters such as validity and reliability, thus avoiding restrictions to the applicability of the instrument.
What radiography and photogrammetry-based methods used to assess the cervical spine posture in the sagittal plane are valid and/or reliable?
Systematic searches were conducted following Meta-analysis of Observational Studies in Epidemiology guidelines. https://www.selleckchem.com/products/ms-275.html Methodological quality was assessed according to the Brink & Louw appraisal tool.
Twenty-one studies were included in the qualitative analysis. Twenty different methods of calculating cervical spine posture in the sagittal plane were found. Two studies included validation measures, 16 studies assessed inter-rater reliability, and 17 studies assessed intra-rater reliability. Fourteen studies were included for the quantitative analysis. The meta-analysis shows thd the respective information on validity and reliability. This panorama facilitates the choice of method when conducting radiography or photogrammetry-based assessment of the cervical spine in the sagittal plane. In addition, it shows the need for new studies that investigate the accuracy and precision of these methods for their possible use in larger studies.
Balance is considered to be task-specific as indicated by studies reporting only small-sized and non-significant correlations between types of balance (e.g., static, dynamic). However, it remains unclear whether these associations differ by age and the comparability of studies is limited due to methodological inconsistencies.
Are associations between types of balance performance affected by age in children, adolescents, and young adults?
Static, dynamic, and proactive balance performance was assessed in 30 children (7.6 ± 0.6 years), 43 adolescents (14.7 ± 0.5 years), and 54 young adults (22.8 ± 2.8 years) using the same standardized balance tests. Pearson's correlation coefficients (r) were calculated for associations between types of balance and statistically compared to detect differences between age groups.
Except for the association between static (i.e., medio-lateral [M/L] sway) and proactive (Y-balance test) balance performance in young adults (r = .319, p < .05), our analyses revealed smalll and hardly affected by age in youth. Therefore, they should be trained and tested individually in children, adolescents, and young adults.
Surgical interventions for obstructive sleep apnea (OSA) are less effective in obese than in normal-weight children. However, the mechanisms that underpin this relationship are not fully understood. Therefore, this study aimed to explore how body weight influences upper airway collapse and treatment outcome in children with OSA.
We conducted a retrospective analysis of prospectively collected data on polysomnography, drug-induced sleep endoscopy (DISE), and treatment outcome in otherwise healthy children with OSA. Associations between body mass index (BMI) z-score and upper airway collapse during DISE were assessed using logistic regression modelling. Treatment success was defined as obstructive apnea-hypopnea index (oAHI)<5 events/hour and cure as oAHI<2 events/hour with obstructive apnea index<1 event/hour.
A total of 139 children were included [median (Q1─Q3); age 4.5 (3.1─8.4) years; BMI z-score 0.3 (-0.8 to 1.4); oAHI 10.8 (6.8─18.0) events/hour]. Twenty-five of them were overweight and 21 were obese. After adjusting for age and history of upper airway surgery, BMI z-score was significantly correlated with circumferential upper airway collapse during DISE (odds ratio 1.67; 95% confidence interval 1.12─2.65; P=0.011). Outcome of DISE-directed treatment was similar in normal-weight (success 91.4%; cure 78.5%), overweight (success 88.0%; cure 80.0%), and obese (success 90.5%; cure 76.5%) children. Children with circumferential collapse responded better to continuous positive airway pressure than to (adeno)tonsillectomy.
Increasing body weight is associated with circumferential upper airway collapse during DISE and, accordingly, may require treatment strategies other than (adeno)tonsillectomy.
Increasing body weight is associated with circumferential upper airway collapse during DISE and, accordingly, may require treatment strategies other than (adeno)tonsillectomy.
Sleep timing is related to several risk factors for angina pectoris (AP), such as obesity and diabetes. This study was designed to evaluate the relationship between sleep timing and AP, specifically whether later bedtime was associated with AP in middle-aged and older adults.
This community-based study was based on the Sleep Heart Health Study cohort and included 4710 participants (45.9% men, aged 63.3±11.0 years). Lifestyle and epidemiological information were obtained from baseline records. Self-reported sleep measures provided information on bedtime and wake-up time of weekdays and weekends. Individuals were divided into three categories according to bedtime (≤2200, 2201-2300, and >2300). Odds ratios (OR) and 95% confidence intervals (CIs) of AP for bedtimes were estimated with multivariate logistic regression analysis.
The prevalence of AP was 44.2% and the distribution of weekday bedtimes ≤2200, 2201-2300
and >2300 were 36.6%, 47.5% and 46.0%, respectively. After adjusting for potential confounders, weekday bedtimes >2300 (OR 1.34; 95% CI 1.13-1.60; P=0.001) and 2201-2300 (OR 1.54; 95% CI 1.29-1.82; P<0.001) were significantly associated with an increased risk of AP compared with the reference group (≤2200). In addition, weekend bedtimes >2300 (OR 1.44; 95% CI 1.20-1.73; P<0.001) and 2201-2300 (OR 1.70; 95% CI 1.40-2.05; P<0.001) increased the risk of AP.
Later bedtimes on both weekdays and weekends were significantly associated with an increased prevalence of AP. Early bedtimes may help people decrease the risk of AP.
Later bedtimes on both weekdays and weekends were significantly associated with an increased prevalence of AP. Early bedtimes may help people decrease the risk of AP.
There are numerous radiography and photogrammetry-based methods of assessing the cervical spine posture in the sagittal plane. The choice of instrument should be based on scientific parameters such as validity and reliability, thus avoiding restrictions to the applicability of the instrument.
What radiography and photogrammetry-based methods used to assess the cervical spine posture in the sagittal plane are valid and/or reliable?
Systematic searches were conducted following Meta-analysis of Observational Studies in Epidemiology guidelines. https://www.selleckchem.com/products/ms-275.html Methodological quality was assessed according to the Brink & Louw appraisal tool.
Twenty-one studies were included in the qualitative analysis. Twenty different methods of calculating cervical spine posture in the sagittal plane were found. Two studies included validation measures, 16 studies assessed inter-rater reliability, and 17 studies assessed intra-rater reliability. Fourteen studies were included for the quantitative analysis. The meta-analysis shows thd the respective information on validity and reliability. This panorama facilitates the choice of method when conducting radiography or photogrammetry-based assessment of the cervical spine in the sagittal plane. In addition, it shows the need for new studies that investigate the accuracy and precision of these methods for their possible use in larger studies.
Balance is considered to be task-specific as indicated by studies reporting only small-sized and non-significant correlations between types of balance (e.g., static, dynamic). However, it remains unclear whether these associations differ by age and the comparability of studies is limited due to methodological inconsistencies.
Are associations between types of balance performance affected by age in children, adolescents, and young adults?
Static, dynamic, and proactive balance performance was assessed in 30 children (7.6 ± 0.6 years), 43 adolescents (14.7 ± 0.5 years), and 54 young adults (22.8 ± 2.8 years) using the same standardized balance tests. Pearson's correlation coefficients (r) were calculated for associations between types of balance and statistically compared to detect differences between age groups.
Except for the association between static (i.e., medio-lateral [M/L] sway) and proactive (Y-balance test) balance performance in young adults (r = .319, p < .05), our analyses revealed smalll and hardly affected by age in youth. Therefore, they should be trained and tested individually in children, adolescents, and young adults.
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