Development of a Simplified Pediatric Obstructive Sleep Apnea (OSA) Screening Tool PDF Download
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Author: Jo Koontz Cronly
Publisher:
ISBN:
Category :
Languages : en
Pages : 58
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Book Description
Background: Obstructive sleep apnea has become recognized as one of the most common, under-diagnosed chronic diseases. Recently studies have shown increased numbers among the pediatric and adolescent population. OSA in children is associated with behavioral problems, poor school achievements, and in severe cases, pulmonary hypertension. OSA is often the Achilles heel of pediatric sedation and analgesic programs; during sedation, children with OSA have an increased vulnerability of their airway undergoing pharyngeal collapse and of having upper airway obstruction. Consequently, pediatric dentists who practice sedation dentistry should exercise extra precautions when treating patients with risk of sleep apnea. Currently there is no screening tool used in pediatric dentistry for diagnosing OSA during the pre-operative appointment or consultation for patients undergoing minimal and moderate oral conscious sedation. The purpose of this study was to develop and test a concise and easy-to-use questionnaire as a screening tool to aid in the diagnosis of OSA in pediatric patients. Materials and Methods: A retrospective chart review of 180 patients under the age of 18, who completed a polysomnogram at the VCU Center for Sleep Medicine between February 2011 and February 2013. A validated adult questionnaire, STOPBANG, was modified using more typical pediatric risk factors for OSA: presence of snoring (S), tonsillar hypertrophy (T1), tiredness; pESS>10 (T2), observed obstruction (O), neuroPsych-behavioral symptoms such as ADHD or daytime irritability (P), BMI percentile for age (B), age at diagnostic screening (A), presence of neuromuscular disorder (N), and presence of genetic/congenital disorder (G). A positive scoring from these variables was measured against the standard OSA measure, Apnea-Hypopnea Index. A multiple logistic regression analysis tested for relationships. Results: There was a statistically significant relationship P= .0007 for the S(T1)OPBANG scale, with a minimum of 4 variables needed to have a sensitivity of 57% and a specificity of 78%. There was also a statistically significant relationship P= .0040 for the S(T2)OPBANG, the cutoff>5 yielding sensitivity=36%, and specificity=90%. Only obstruction, BMI, and age showed a strong significant relationship to OSA. The presence of an obstruction was positively related to apnea (P = 0.0010). Most of the other components had an odds-ratio larger than one (indicating a nominally positive relationship). Conclusions: While both STOPBANG screening tools showed a statistically significant relationship, only obstruction, BMI, and age showed a predictive relationship to OSA. Consequently, consideration of other risk factors may be beneficial for future studies.
Author: Jo Koontz Cronly
Publisher:
ISBN:
Category :
Languages : en
Pages : 58
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Book Description
Background: Obstructive sleep apnea has become recognized as one of the most common, under-diagnosed chronic diseases. Recently studies have shown increased numbers among the pediatric and adolescent population. OSA in children is associated with behavioral problems, poor school achievements, and in severe cases, pulmonary hypertension. OSA is often the Achilles heel of pediatric sedation and analgesic programs; during sedation, children with OSA have an increased vulnerability of their airway undergoing pharyngeal collapse and of having upper airway obstruction. Consequently, pediatric dentists who practice sedation dentistry should exercise extra precautions when treating patients with risk of sleep apnea. Currently there is no screening tool used in pediatric dentistry for diagnosing OSA during the pre-operative appointment or consultation for patients undergoing minimal and moderate oral conscious sedation. The purpose of this study was to develop and test a concise and easy-to-use questionnaire as a screening tool to aid in the diagnosis of OSA in pediatric patients. Materials and Methods: A retrospective chart review of 180 patients under the age of 18, who completed a polysomnogram at the VCU Center for Sleep Medicine between February 2011 and February 2013. A validated adult questionnaire, STOPBANG, was modified using more typical pediatric risk factors for OSA: presence of snoring (S), tonsillar hypertrophy (T1), tiredness; pESS>10 (T2), observed obstruction (O), neuroPsych-behavioral symptoms such as ADHD or daytime irritability (P), BMI percentile for age (B), age at diagnostic screening (A), presence of neuromuscular disorder (N), and presence of genetic/congenital disorder (G). A positive scoring from these variables was measured against the standard OSA measure, Apnea-Hypopnea Index. A multiple logistic regression analysis tested for relationships. Results: There was a statistically significant relationship P= .0007 for the S(T1)OPBANG scale, with a minimum of 4 variables needed to have a sensitivity of 57% and a specificity of 78%. There was also a statistically significant relationship P= .0040 for the S(T2)OPBANG, the cutoff>5 yielding sensitivity=36%, and specificity=90%. Only obstruction, BMI, and age showed a strong significant relationship to OSA. The presence of an obstruction was positively related to apnea (P = 0.0010). Most of the other components had an odds-ratio larger than one (indicating a nominally positive relationship). Conclusions: While both STOPBANG screening tools showed a statistically significant relationship, only obstruction, BMI, and age showed a predictive relationship to OSA. Consequently, consideration of other risk factors may be beneficial for future studies.
Author: Mostafa Altalibi
Publisher:
ISBN:
Category : Orthodontics, Corrective
Languages : en
Pages : 96
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Book Description
Purpose: To develop a physician screening index for the oral and facial assessment of the orthodontic treatment-need in pediatric patients with Obstructive Sleep Apnea (OSA) that may diminish the severity of their OSA symptoms. Methods: Based on the available literature and WHO guidelines for index development, a draft index was produced, and subjected to multiple iterative revisions based on the feedback from: 1) the Index Development Group; 2) the External Review Group; and 3) the Steering Committee. Once the index was formalized, it was subjected to reliability testing Results: Based on the feedback from the Index Development Group, the External Review Group and the Steering Committee, an index has been developed that is simple, easy to understand and easy to use. The index also exhibits a fair to substantial inter-rater reliability, and moderate to almost perfect intra-rater reliability. The orthodontic residents scored better than the medical residents in the reliability tests and took less time to use the index. The average time to use the index on 15 cases was 17:14min. Conclusions: This is a much needed, simple, and easy to use index that is reliable among orthodontic residents and among medical residents.
Author: Ujjwal Ramtekkar
Publisher: MDPI
ISBN: 3038979384
Category : Medical
Languages : en
Pages : 160
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Book Description
Sleep-related symptoms are common in the majority of psychiatric diagnostic categories. The overlap of sleep and psychiatric disorders have been demonstrated in numerous studies. The understanding of sleep and child psychiatry has progressively evolved in the last decade and newer insights have developed regarding the complex interaction between sleep and psychopathology. This collection of articles represents updates on sleep and psychiatric disorders with medical and neurological co-morbidities in children and adolescents.
Author: American Academy of Pediatrics Section on Pediatric Pulmonology and Sleep Medicine
Publisher:
ISBN: 9781610026529
Category :
Languages : en
Pages : 1200
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Book Description
Completely revised and updated, the second edition of this authoritative guide provides the latest information on the diagnosis, treatment, and ongoing management of pulmonary issues in children. The book covers genetic, congenital, and allergic conditions, as well as acquired and infectious respiratory ailments. Pulmonary issues related to other systemic disorders are also covered, along with respiratory care and pediatric sleep medicine. More than 300 finely detailed images complement the text. New Second Edition Features Expanded content on sleep medicine, including sleep development and maturation, insomnia, parasomnias, sleep-related movement disorders, and obstructive sleep apnea Cystic fibrosis newborn screening and CFTR-related metabolic syndrome Expanded coverage of pneumonia, including when caused by COVID-19 Expanded coverage of primary ciliary dyskinesia Vaping and other forms of nicotine exposure Content Highlights Foundation--anatomy; physiology; physical examination; pulmonary testing; imaging; and bronchoscopy Allergic Conditions--bronchopulmonary aspergillosis; hypersensitivity pneumonitis; eosinophilic pneumonia; and asthma Anatomical Disorders--congenital abnormalities of the upper airway; congenital lung anomalies; and chest wall and spinal deformities Upper Airway Infections--croup, epiglottitis, and bacterial tracheitis Lower Airway Infections--bronchiectasis; bronchiolitis; viral pneumonia (including when caused by COVID-19); nonviral pneumonia; complications of pneumonia; recurrent pneumonia; tuberculosis; and nontuberculous mycobacteria Noninfectious Pulmonary Disorders--atelectasis; respiratory disorders associated with systemic inflammatory diseases; interstitial lung disease; bronchopulmonary dysplasia; pleural effusion (noninfectious); pneumothorax and pneumomediastinum; and pulmonary hemorrhage Pediatric Sleep Medicine--sleep development and maturation; obstructive sleep apnea; home sleep testing; sleep-related movement disorders; insomnia; parasomnias; narcolepsy and other disorders of excessive somnolence; sudden infant death syndrome and brief resolved unexplained events; and congenital central hypoventilation syndrome Other Pulmonary Issues--acute aspiration and aspiration-related lung disease; lung transplant; asthma and other respiratory disorders associated with obesity; and functional respiratory disorders Genetic Disorders--cystic fibrosis; cystic fibrosis newborn screening and CFTR-related metabolic syndrome; and primary ciliary dyskinesia and other genetic lung diseases Lung Disease Associated With Systemic Disorders--respiratory considerations in children with cardiac disease; lung disease associated with endocrine disorders; pulmonary complications of gastrointestinal diseases; pulmonary complications of sickle cell disease; pulmonary manifestations of oncological disease and treatment; pulmonary complications of immunologic disorders; and pulmonary complications of neuromuscular disorders Treating and Managing Pulmonary Disease--airway clearance techniques; aerosol delivery of medication; bronchodilators; antibiotics for pulmonary conditions; nutritional aspects of pulmonary conditions; oxygen therapy; and nicotine and tobacco
Author: Bruno Bissonnette
Publisher: PMPH-USA
ISBN: 1607952130
Category : Medical
Languages : en
Pages : 2286
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Book Description
No longer merely a subspecialty, pediatric anesthesia is now a professional entity in its own right, as is amply demonstrated in this comprehensive addition to the medical and surgical literature. Pediatric Anesthesia: Basic Principles-State of the Art-Future comprises the contributions of 150 experts in the field from all over the world, providing this book with a truly global perspective. This textbook will help anesthesiologists already interested in pediatric anesthesia to the knowledge and skills inherent to the safe practice of anesthesia for infants and children.
Author: Azmeh Shahid
Publisher: Springer Science & Business Media
ISBN: 1441998926
Category : Medical
Languages : en
Pages : 403
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Book Description
There are at least four reasons why a sleep clinician should be familiar with rating scales that evaluate different facets of sleep. First, the use of scales facilitates a quick and accurate assessment of a complex clinical problem. In three or four minutes (the time to review ten standard scales), a clinician can come to a broad understanding of the patient in question. For example, a selection of scales might indicate that an individual is sleepy but not fatigued; lacking alertness with no insomnia; presenting with no symptoms of narcolepsy or restless legs but showing clear features of apnea; exhibiting depression and a history of significant alcohol problems. This information can be used to direct the consultation to those issues perceived as most relevant, and can even provide a springboard for explaining the benefits of certain treatment approaches or the potential corollaries of allowing the status quo to continue. Second, rating scales can provide a clinician with an enhanced vocabulary or language, improving his or her understanding of each patient. In the case of the sleep specialist, a scale can help him to distinguish fatigue from sleepiness in a patient, or elucidate the differences between sleepiness and alertness (which is not merely the inverse of the former). Sleep scales are developed by researchers and clinicians who have spent years in their field, carefully honing their preferred methods for assessing certain brain states or characteristic features of a condition. Thus, scales provide clinicians with a repertoire of questions, allowing them to draw upon the extensive experience of their colleagues when attempting to tease apart nuanced problems. Third, some scales are helpful for tracking a patient’s progress. A particular patient may not remember how alert he felt on a series of different stimulant medications. Scale assessments administered periodically over the course of treatment provide an objective record of the intervention, allowing the clinician to examine and possibly reassess her approach to the patient. Finally, for individuals conducting a double-blind crossover trial or a straightforward clinical practice audit, those who are interested in research will find that their own clinics become a source of great discovery. Scales provide standardized measures that allow colleagues across cities and countries to coordinate their practices. They enable the replication of previous studies and facilitate the organization and dissemination of new research in a way that is accessible and rapid. As the emphasis placed on evidence-based care grows, a clinician’s ability to assess his or her own practice and its relation to the wider medical community becomes invaluable. Scales make this kind of standardization possible, just as they enable the research efforts that help to formulate those standards. The majority of Rating Scales in Sleep and Sleep Disorders:100 Scales for Clinical Practice is devoted to briefly discussing individual scales. When possible, an example of the scale is provided so that readers may gain a sense of the instrument’s content. Groundbreaking and the first of its kind to conceptualize and organize the essential scales used in sleep medicine, Rating Scales in Sleep and Sleep Disorders:100 Scales for Clinical Practice is an invaluable resource for all clinicians and researchers interested in sleep disorders.
Author: Leila Kheirandish-Gozal
Publisher: Springer Science & Business Media
ISBN: 1607617250
Category : Medical
Languages : en
Pages : 582
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Book Description
Sleep Disordered Breathing in Children: A Comprehensive Clinical Guide to Evaluation and Treatment is a comprehensive, timely and up-to-date review of pediatric sleep disordered breathing (SDB) and offers a thorough focus on several key areas: namely, the normal development and maturation of the airway and breathing during sleep, the techniques that are in place for assessment of SDB in children, the clinical manifestations and characteristics of several pediatric populations at risk for SDB, the implications of SDB in various end-organ systems, and, finally, a critical review of the evidence on current therapeutic approaches. This unique and complete text is of welcome interest to all practicing physicians and healthcare professionals who evaluate children with sleep problems -- namely pulmonologists, pediatricians, sleep physicians, pediatric neurologists, pediatric otolaryngologists, and family practitioners, as well as clinical researchers, pediatric nurse practitioners and respiratory therapists. Written by a distinguished and international panel of authors who are renowned experts in their field and who offer an expanded view of the problems associated with SDB, Sleep Disordered Breathing in Children: A Comprehensive Clinical Guide to Evaluation and Treatment is an indispensible resource for all physicians who evaluate children for sleep-disordered breathing.
Author: Fernando Vaquerizo Villar
Publisher: Springer Nature
ISBN: 3031328329
Category : Technology & Engineering
Languages : en
Pages : 104
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Book Description
This book describes the application of novel signal processing algorithms to improve the diagnostic capability of the blood oxygen saturation signal (SpO2) from nocturnal oximetry in the simplification of pediatric obstructive sleep apnea (OSA) diagnosis. For this purpose, 3196 SpO2 recordings from three different databases were analyzed using feature-engineering and deep-learning methodologies. Particularly, three novel feature extraction algorithms (bispectrum, wavelet, and detrended fluctuation analysis), as well as a novel deep-learning architecture based on convolutional neural networks are proposed. The proposed feature-engineering and deep-learning models outperformed conventional features from the oximetry signal, as well as state-of-the-art approaches. On the one hand, this book shows that bispectrum, wavelet, and detrended fluctuation analysis can be used to characterize changes in the SpO2 signal caused by apneic events in pediatric subjects. On the other hand, it demonstrates that deep-learning algorithms can learn complex features from oximetry dynamics that allow to enhance the diagnostic capability of nocturnal oximetry in the context of childhood OSA. All in all, this book offers a comprehensive and timely guide to the use of signal processing and AI methods in the diagnosis of pediatric OSA, including novel methodological insights concerning the automated analysis of the oximetry signal. It also discusses some open questions for future research.
Author: Nico de Vries
Publisher: Thieme
ISBN: 3132403660
Category : Medical
Languages : en
Pages : 442
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Book Description
The definitive resource on the innovative use of DISE for obstructive sleep apnea Obstructive sleep apnea is the most prevalent sleep-related breathing disorder, impacting an estimated 1.36 billion people worldwide. In the past, OSA was almost exclusively treated with Continuous Positive Airway Pressure (CPAP), however, dynamic assessment of upper airway obstruction with Drug-Induced Sleep Endoscopy (DISE) has been instrumental in developing efficacious alternatives. Drug-Induced Sleep Endoscopy: Diagnostic and Therapeutic Applications by Nico de Vries, Ottavio Piccin, Olivier Vanderveken, and Claudio Vicini is the first textbook on DISE written by world-renowned sleep medicine pioneers. Twenty-four chapters feature contributions from an impressive group of multidisciplinary international experts. Foundational chapters encompass indications, contraindications, informed consent, organization and logistics, patient preparation, and drugs used in DISE. Subsequent chapters focus on treatment outcomes, the role of DISE in therapeutic decision making and upper airway stimulation, pediatric sleep endoscopy, craniofacial syndromes, advanced techniques, and more. Key Highlights Comprehensive video library highlights common and rare DISE findings A full spectrum of sleep disordered breathing and OSA topics, from historic to future perspectives Insightful clinical pearls on preventing errors and managing complications including concentric and epiglottis collapse Discussion of controversial DISE applications including oral appliances and positional and combination therapies This unique book is essential reading for otolaryngology residents, fellows, and surgeons. Clinicians in other specialties involved in sleep medicine will also benefit from this reference, including pulmonologists, neurologists, neurophysiologists, maxillofacial surgeons, and anesthesiologists.
Author: Brendan Glowacki
Publisher:
ISBN:
Category : Primary care (Medicine)
Languages : en
Pages : 112
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Book Description
