Study Objectives: The success of surgical treatment for pediatric sleep-disordered breathing is typically assessed using the mixed and obstructive apnea-hypopnea index (MOAHI). Although an important metric, previous work has shown that snoring and stertor are also associated with sleep disruption. Our aim was to assess the efficacy of surgery using the Sonomat (Sonomedical Pty Ltd), a noncontact sleep assessment system, that accurately records complete and partial upper airway obstruction.
View Article and Find Full Text PDFIntroduction: Pediatric sleep disordered breathing (SDB) is characterized by long periods of partial upper airway obstruction (UAO) with low apnea-hypopnea indices (AHI). By measuring snoring and stertor, Sonomat studies allow quantification of these periods of partial UAO.
Aim: To determine whether transcutaneous CO (TcCO ) levels correlate with increasing levels of partial UAO and to examine patterns of ΔTcCo in the transitions from (a) wakefulness to sleep and (b) non-rapid eye movement (NREM) to rapid eye movement (REM) sleep.
Congenital central hypoventilation syndrome (CCHS) is a rare disorder characterized by alveolar hypoventilation and autonomic dysregulation secondary to mutations of the genes. Treatment consists of assisted ventilation using positive pressure ventilators via tracheostomy, bi-level positive airway pressure (BPAP), negative pressure ventilators, or diaphragm pacing. Previous case reports have highlighted early use of nasal non-invasive BPAP use in infants with CCHS.
View Article and Find Full Text PDFPurpose: Polysomnography is not recommended for children at home and does not adequately capture partial upper airway obstruction (snoring and stertor), the dominant pathology in pediatric sleep-disordered breathing. New methods are required for assessment. Aims were to assess sleep disruption linked to partial upper airway obstruction and to evaluate unattended Sonomat use in a large group of children at home.
View Article and Find Full Text PDFSci Total Environ
February 2019
With increasing urgency to build earthworks projects to protect against flooding from climate change and mitigate exposure to pollutants in degraded urban soils, many cities could experience increased demand for soil of between 10 and 35 million t in coming decades. This study showed that building construction in New York City (NYC) produces an estimated 1.7 × 10 t of surplus clean native soil (mostly glacial sediments) each year and could be an important source to meet future urban soil demand.
View Article and Find Full Text PDFMayo Clin Proc Innov Qual Outcomes
March 2018
Objective: To compare perinatal outcomes, blood pressures throughout pregnancy, rates of hypertensive disorders of pregnancy, preeclampsia, gestational diabetes mellitus, and immediate obstetric outcomes in adolescents younger than 20 years at delivery and those in the 20- to 34-year age group.
Patients And Methods: Questionnaires were administered to pregnant women at Campbelltown and Liverpool hospitals within South West Sydney, Australia, as part of a broader study of sleep-disordered breathing in pregnancy between February 1, 2009, and February 28, 2013. Data collected included demographic data, blood pressure readings, pregnancy complications, delivery type, and neonatal outcomes.
Am J Respir Crit Care Med
September 2018
Background: There is recent interest exploring the possible impact of sleep disordered breathing on the mechanisms of preeclampsia. A biomarker of preeclampsia, soluble fms-like tyrosine kinase-1, has come to prominence in recent years. The aim of this study was to investigate the relationship between continuous positive airway pressure treatment, sleep disordered breathing and soluble fms-like tyrosine kinase-1 concentrations during pregnancy.
View Article and Find Full Text PDFLong-term non-invasive ventilation (NIV) is a common modality of breathing support used for a range of sleep and respiratory disorders. The aim of this scoping review was to provide a summary of the literature relevant to long-term NIV use in children. We used systematic methodology to identify 11,581 studies with final inclusion of 289.
View Article and Find Full Text PDFStudy Objectives: To validate the Sonomat against polysomnography (PSG) metrics in children and to objectively measure snoring and stertor to produce a quantitative indicator of partial upper airway obstruction that accurately reflects the pathology of pediatric sleep-disordered breathing (SDB).
Methods: Simultaneous PSG and Sonomat recordings were performed in 76 children (46 male, age 5.8 ± 2.
Positive airway pressure (PAP) treatment has been shown to have a modest effect on ambulatory blood pressure (BP) in patients with obstructive sleep apnea (OSA). However, there is a paucity of data on the effect of PAP therapy on rapid, yet significant, BP swings during sleep, particularly in obesity hypoventilation syndrome (OHS). The present study hypothesizes that PAP therapy will improve nocturnal BP on the first treatment night (titration PAP) in OHS patients with underlying OSA, and that these improvements will become more significant with 6 wk of PAP therapy.
View Article and Find Full Text PDFBackground: Computed tomography (CT) clarity has significantly improved since it became widely available in the early 1980s, making the utility and benefit of contrast material for image quality of the abdomen and pelvis uncertain, and so far, minimally studied.
Objectives: This study sought to assess the efficacy of a noncontrast CT scan of the abdomen and pelvis by evaluating patients presenting to the emergency department (ED) with acute nontraumatic abdominal pain by following them for 7 days and observing for signs and symptoms of clinically significant acute emergent pathology.
Methods: We enrolled, and for 7 days followed, a prospective observational convenience sample of patients who received a noncontrast CT scan of the abdomen and pelvis in the ED for acute nontraumatic abdominal pain.
Study Objectives: To evaluate the ability of the Sonomat to diagnose obstructive sleep apnea (OSA).
Design: Prospective and randomized.
Setting: Sleep laboratory and home.
Study Objectives: Preeclampsia affects 5% to 7% of pregnancies, is strongly associated with low birth weight and fetal death, and is accompanied by sleep disordered breathing. We hypothesized that sleep disordered breathing may link preeclampsia with reduced fetal movements (a marker of fetal health), and that treatment of sleep disordered breathing might improve fetal activity during sleep.
Design, Setting, And Participants: First, a method of fetal movement recording was validated against ultrasound in 20 normal third trimester pregnancies.
Objective: The objective of this study was to determine what impact the omission of respiratory events scored during wake epochs has on the generation of the apnea/hypopnea index (AHI) using computerised polysomnography (PSG).
Materials And Methods: Sixty diagnostic PSG recordings were scored using the recommended method of sleep staging with epochs. In addition, absolute sleep scoring criteria was used to calculate the total sleep time (TST).
Solid waste management in developing countries is often unsustainable, relying on uncontrolled disposal in waste dumps. Particular problems arise from the disposal of treatment residues generated by removing arsenic (As) from drinking water because As can be highly mobile and has the potential to leach back to ground and surface waters. This paper reviews the disposal of water treatment wastes containing As, with a particular emphasis on stabilisation/solidification (S/S) technologies which are currently used to treat industrial wastes containing As.
View Article and Find Full Text PDFUnlabelled: Overnight oxyhaemoglobin desaturation is related to AMS. AMS can be debilitating and may require descent. Positive pressure ventilation during sleep at high altitude may prevent AMS and therefore be useful in people travelling to high altitude, who are known to suffer from AMS.
View Article and Find Full Text PDFThe aim of this study was to examine sleep architecture at high altitude and its relationship to periodic breathing during incremental increases in altitude. Nineteen normal, sea level-dwelling volunteers were studied at sea level and five altitudes in the Nepal Himalaya. Morning arterial blood gases and overnight polysomnography were performed in 14 subjects at altitudes: 0, 1400, 3500, 3900, 4200 and 5000 m above sea level.
View Article and Find Full Text PDFBackground And Objective: While recent meta-analyses suggest that OSA elevates daytime blood pressure (BP), most studies have included patients with mild hypertension, so CPAP treatment has only reduced BP by 2-3 mm Hg. To determine the strength of the OSA-BP relationship, this study examined the effect of CPAP in a cohort where severe OSA and under-treated hypertension coexist.
Methods: Baseline demographic and sleep study data were recorded in 221 consecutive patients referred for sleep studies in Samoa.