Detection of pediatric obstructive sleep apnea using a multilayer perceptron model based on single-channel oxygen saturation or clinical features.

Purpose: This study was performed to develop and evaluate a method of detecting pediatric obstructive sleep apnea (OSA) using a multilayer perceptron (MLP) model based on single-channel nocturnal oxygen saturation (SpO) with or without clinical data.

Methods: Polysomnography data for 888 children with OSA and 417 unaffected children were included. An MLP model was proposed based on the features obtained from SpO and combined features of SpO and clinical data to screen symptomatic children for OSA.

Sleep disorders in cystic fibrosis: A systematic review and meta-analysis.

Cystic fibrosis (CF) is a genetic disorder that leads to airway mucus accumulation, chronic inflammation, and recurrent respiratory infections - all likely impacting sleep. However, controlled studies of sleep in CF patients are limited, and have shown mixed results. We reviewed all publications on CF and sleep indexed in PubMed, CINAHL, and Scopus through April 2019.

Identifying Morphological Patterns of Hippocampal Atrophy in Patients With Mesial Temporal Lobe Epilepsy and Alzheimer Disease.

Mesial temporal lobe epilepsy (MTLE) and Alzheimer's disease (AD) are two distinct neurological disorders associated with hippocampal atrophy. Our goal is to analyze the morphologic patterns of hippocampal atrophy to better understand the underlying pathological and clinical characteristics of the two conditions. Twenty-five patients with AD and 20 healthy controls with matched age and gender were recruited into the AD group.

High prevalence of periodic limb movements of sleep in children with Down syndrome.

Study Objectives: Increased periodic limb movements of sleep (PLMS), > 5 events/h, are present in 1.2% to 7.7% of healthy children and associated with hypertension, attention deficit, and hyperactivity.

The evaluation and management of respiratory disease in children with Down syndrome (DS).

Children with Down syndrome (DS) have wide range of respiratory problems. Although underlying abnormalities in the respiratory system are important causes of morbidity and mortality in children with DS, particularly in the young, abnormalities in other organ systems may also impact respiratory function. A comprehensive evaluation of the child with DS and respiratory disease may prevent short-term morbidity and mortality, and reduce the incidence of complications in the long term.

The facial morphology in Down syndrome: A 3D comparison of patients with and without obstructive sleep apnea.

Obstructive sleep apnea (OSA) occurs at a high prevalence in patients with Down syndrome (DS). A polysomnogram, which is often cumbersome and challenging, remains the gold standard method of diagnosing OSA. OSA in patients with DS is often attributed to skeletal and soft-tissue structural alterations that are characteristic of the DS phenotype; as such, we hypothesized that assessing anthropometric facial measurements may be predictive of OSA in patients with DS.

Isolated mild sleep-associated hypoventilation in children with Down syndrome.

Introduction: Children with Down syndrome (DS) have a high incidence of obstructive sleep apnea (OSA) that is often associated with hypoventilation. Little is known, however, about the prevalence of sleep-associated hypoventilation independent of OSA in these children.

Methods: Retrospective chart review of all children with DS under 18 years of age undergoing polysomnography at a tertiary care paediatric hospital during a 2-year period.

A predictive model for obstructive sleep apnea and Down syndrome.

Obstructive sleep apnea (OSA) occurs frequently in people with Down syndrome (DS) with reported prevalences ranging between 55% and 97%, compared to 1-4% in the neurotypical pediatric population. Sleep studies are often uncomfortable, costly, and poorly tolerated by individuals with DS. The objective of this study was to construct a tool to identify individuals with DS unlikely to have moderate or severe sleep OSA and in whom sleep studies might offer little benefit.

Craniofacial features as assessed by lateral cephalometric measurements in children with Down syndrome.

Objective: The objective of the present study is to examine the craniofacial development of patients with Down syndrome (DS) and compare them with a neurotypical population.

Methods: This study is a cross-sectional analysis of lateral cephalometric radiographs of participants with DS. The study population consisted of children and young adults with DS aged 3-25 years.

Affordable access to care for the undocumented.

How do you tell a sick kid that nobody cares if he gets better? That's an exaggeration, of course, but it is the fundamental message our society sends when we tell him that, because he and his family are undocumented immigrants, we are unwilling to extend them access to affordable and reliable health insurance. One major shortcoming of the Affordable Care Act is its specific exclusion of the almost twelve million undocumented immigrants-including millions of children-in this country from access to the state and federal insurance exchanges where coverage can be purchased. It is true that providing undocumented immigrants access to the exchanges and subsidies mandated by the ACA would require additional funding.

The diagnosis and management of common sleep disorders in adolescents.

Purpose Of Review: Sleep problems in adolescents are very common and negatively impact the quality of their health and lives, yet often go undiagnosed. This review is meant to familiarize pediatricians with some of the more commonly encountered sleep disorders in this age group, and to review their diagnosis and management.

Recent Findings: Recent findings reinforce the ubiquity of insufficient and poor-quality sleep in teens and their consequences on physical and mental health, cognition, and behavior.

Bronchial carcinoid in college freshman with persistent focal wheeze.

Purpose: To bring attention to a rare diagnosis in the pediatric population that is in the differential diagnosis for not well-controlled asthma.

Data Sources: Case presentation.

Conclusions: Pulmonary carcinoid tumors are rare and usually present late in adolescence.

Management of obstructive sleep apnea associated with Down syndrome and other craniofacial dysmorphologies.

Purpose Of Review: Obstructive sleep apnea (OSA) is very common in children with Down syndrome and other craniofacial abnormalities and causes significant deleterious physical, developmental, and behavioral outcomes. OSA in these individuals is generally more difficult to treat than in other children, because of increased postoperative complications and lower success rates for adenotonsillectomy, the mainstay of treatment for otherwise healthy children with OSA.

Recent Findings: There is a growing number of treatment options for these children, which can provide an alternative to continuous positive airway pressure or tracheostomy.

Parental perceptions of sleep disturbances and sleep-disordered breathing in children with Down syndrome.

Objectives: Children with Down syndrome (DS) have increased difficulty initiating and maintaining sleep (DIMS), excessive daytime sleepiness (EDS), and obstructive sleep apnea (OSA). As part of a quality improvement initiative, parents of children enrolled in the Children's Hospital Boston Down Syndrome Program were surveyed about their child's sleep and breathing patterns while asleep.

Methods: An anonymous Internet-based questionnaire was used in the study.

Some infants with Down syndrome spontaneously outgrow their obstructive sleep apnea.

Introduction: Obstructive sleep apnea (OSA) is commonly seen in children with Down syndrome (DS). Though some infants with DS spontaneously outgrow their OSA, it is not clear how often this occurs or how this should affect the choice between surgical and nonsurgical treatment.

Methods: Retrospective chart review of all infants with DS younger than 2 years referred over a 66-month period to Children's Hospital Boston for sleep study because of suspected OSA.

Associations of PM10 with sleep and sleep-disordered breathing in adults from seven U.S. urban areas.

Rationale: Sleep-disordered breathing (SDB), the recurrent episodic disruption of normal breathing during sleep, affects as much as 17% of U.S. adults, and may be more prevalent in poor urban environments.

Many parents report their child's breathing and sleep patterns during overnight sleep study as atypical.

Unlabelled: Many parents report their child's breathing and sleep patterns during overnight sleep study as atypical.

Objective: To determine how closely parents/guardians of children undergoing polysomnography (PSG) felt the breathing and sleep patterns observed during PSG resembled those typically seen at home.

Methods And Subjects: Retrospective chart and post-PSG questionnaire review of 200 consecutive PSGs.

Severe hypothyroidism presenting as obstructive sleep apnea.

A 5-year-old child with Down syndrome (DS) diagnosed with mild to moderate obstructive sleep apnea (OSA) and subsequently found to have severe hypothyroidism is presented. Following 3 months of treatment with levothyroxine, she had full resolution of her OSA. This case underscores the importance of routine thyroid function screening in children with DS and demonstrates that OSA in children with DS can be caused by other underlying medical issues that themselves require therapy, such as the hypothyroidism in this child.