DOES TREATMENT REVERSE THE NEUROCOGNITIVE AND CARDIOVASCULAR SEQUELAE OF SLEEP DISORDERED BREATHING IN CHILDREN?
Funder
National Health and Medical Research Council
Funding Amount
$519,826.00
Summary
Studies in children have shown that disruption to normal sleep patterns resulting from sleep disordered breathing (SDB) has severe consequences for both the cardiovascular system and neurocognition. To date there have been no studies in children to investigate whether treatment of SDB with adenotonsillectomy, which has been shown to reduce sleep fragmentation and neurocognition, also reduces blood pressure.
Alternatives To Polysomnography For Children With Suspected Obstructive Sleep Apnoea.
Funder
National Health and Medical Research Council
Funding Amount
$357,613.00
Summary
Snoring is the cardinal symptom of obstructive sleep apnoea (OSA), a major health issue in childhood with significant impacts on cognition, behaviour and cardiovascular health. Approximately 35% of children snore but only about 10% of those have OSA. Defining OSA in a snoring child requires polysomnography, a technically challenging and expensive test. In this study we will examine a number of simple tests for their predictive power for OSA, developing a tool that will enable clinicians to diagn ....Snoring is the cardinal symptom of obstructive sleep apnoea (OSA), a major health issue in childhood with significant impacts on cognition, behaviour and cardiovascular health. Approximately 35% of children snore but only about 10% of those have OSA. Defining OSA in a snoring child requires polysomnography, a technically challenging and expensive test. In this study we will examine a number of simple tests for their predictive power for OSA, developing a tool that will enable clinicians to diagnose OSA without the need for polysomnography.Read moreRead less
Impact Of Sleep Disordered Breathing On Cardiovascular, Behavioural And Neurocognitive Function In Preschool Children
Funder
National Health and Medical Research Council
Funding Amount
$425,703.00
Summary
Studies in school age children have shown that disruption to normal sleep patterns resulting from sleep disordered breathing (SDB) has severe consequences for both the cardiovascular system and neurocognition. To date there have been limited investigations of the effects of SDB in pre-school children despite the knowledge that disruptions to breathing during sleep are maximal at this age and the central nervous system which is immature and developing at this time, is most vulnerable to injury.
Cardiovascular, Neurophysiological And Neurocognitive Assessments To Define Sleep Disordered Breathing In Children
Funder
National Health and Medical Research Council
Funding Amount
$324,008.00
Summary
Disruptions to breathing during sleep (snoring), known as sleep disordered breathing occurs in up to 27% of children and forms a continuum of symptoms ranging from mild to severe. It has previously been thought that only severe disruptions to breathing, as occurs in obstructive sleep apnoea (OSA), were of clinical significance requiring intervention, however recent studies have shown that even snoring with no currently used signs of altered blood oxygenation levels or sleep disruption can have a ....Disruptions to breathing during sleep (snoring), known as sleep disordered breathing occurs in up to 27% of children and forms a continuum of symptoms ranging from mild to severe. It has previously been thought that only severe disruptions to breathing, as occurs in obstructive sleep apnoea (OSA), were of clinical significance requiring intervention, however recent studies have shown that even snoring with no currently used signs of altered blood oxygenation levels or sleep disruption can have a significant impact on daytime functioning and school performance. It is also known that cardiovascular disease is a long-term consequence of untreated sleep disordered breathing in adults, however the long-term effects on the cardiovascular system in children are unknown. This study will examine both the neurocognitive and cardiovascular effects of a range of severities of sleep disordered breathing in children and will identify new more sensitive markers of sleep disruption in order to predict neurocognitive dysfunction. In order to address this most important issue, this project will combine the expertise of scientists and clinicians in the fields of paediatric sleep, cardiovascular control and neuropsychological assessment from Monash and Melbourne Universities, and the Monash Medical Centre and Royal Children's Hospital.Read moreRead less
What Role Do Cerebral Hypoxia And Sleep Disruption Play In The Neurocognitive Effects Of Paediatric Sleep Disordered Breathing?
Funder
National Health and Medical Research Council
Funding Amount
$558,957.00
Summary
Sleep disordered breathing (SDB) describes a spectrum of disorders caused by obstruction of the upper airway during sleep from simple primary snoring (PS) to obstructive sleep apnoea (OSA). Findings of our recently studies have provided strong evidence that all levels of SDB severity including PS are associated with neurocognitive and behavioural deficits. In this study we will investigate the mechanisms of which underpin these deficits.
The Effect Of Adenotonsillectomy On Neurocognitive Functioning In Children With Upper Airway Obstruction
Funder
National Health and Medical Research Council
Funding Amount
$185,850.00
Summary
Upper airway obstruction during sleep affects up to 3% of all children and is very frequently unrecognised. If severe it causes growth failure, developmental delay and heart failure. However, there is little information on the effects of less severe degrees of upper airway obstruction in children but recent work suggests that reduced academic performance may also be present in children with relatively mild degrees of upper airway obstruction. In particular, the areas most affected appear to be i ....Upper airway obstruction during sleep affects up to 3% of all children and is very frequently unrecognised. If severe it causes growth failure, developmental delay and heart failure. However, there is little information on the effects of less severe degrees of upper airway obstruction in children but recent work suggests that reduced academic performance may also be present in children with relatively mild degrees of upper airway obstruction. In particular, the areas most affected appear to be intelligence, memory, behaviour and attentional capacity . Currently it is unclear whether these deficits are due to sleep disruption or reduced nocturnal oxygen levels. The treatment of upper airway obstruction is the removal of adenoids and tonsils, however, it is unknown whether or not this improves the child's intellectual capacity. This study aims to be one of the first to critically evaluate the impact of upper airway obstruction during sleep on children's intelligence, memory, behaviour and attentional capacity, and the improvements wrought by the removal of the child's tonsils and adenoids.Read moreRead less
Does Adenotonsillectomy Change Vascular Function In Children With Sleep Breathing Disorders?
Funder
National Health and Medical Research Council
Funding Amount
$522,105.00
Summary
Sleep breathing disorders affect 10% of all children and when severe, obstruction in the upper airways causes serious deficits in growth, development, brain function and heart health. But even mild snoring (without obstruction) may also cause poor health in the arteries that supply blood to the brain and heart, as well as the smaller arteries in the arms and legs. In both adults and children with conditions like diabetes and obesity, poor blood vessel health has been shown to greatly increase th ....Sleep breathing disorders affect 10% of all children and when severe, obstruction in the upper airways causes serious deficits in growth, development, brain function and heart health. But even mild snoring (without obstruction) may also cause poor health in the arteries that supply blood to the brain and heart, as well as the smaller arteries in the arms and legs. In both adults and children with conditions like diabetes and obesity, poor blood vessel health has been shown to greatly increase the future risk of heart attacks, angina and strokes. Children with severe sleep breathing disorders (such as sleep apnoea syndrome) are currently treated by removal of the tonsils and adenoids, which typically resolves snoring and improves sleep, but it is not yet known whether there are any benefits for blood vessel health. The earliest signs of blood vessel disease in children are abnormal function of the lining of the blood vessels (endothelial dysfunction) and thickening of the lining of blood vessels (intima media thickness). They precede the adult diseases of atherosclerosis - which causes heart attacks and strokes, and diabetic kidney and eye disease. These changes can be measured accurately and non-invasively using ultrasound imaging of arteries in the neck and arm. Our primary aim is to assess whether changes in blood vessel health occur in children with sleep breathing disorders across the range of severity, with a secondary aim to measure any changes in cardiovascular control during both sleep (when snoring occurs). Most importantly, by assessing children before and after surgery, we will be able to see for the first time whether treatment of childhood snoring improves blood vessel health. This study may have major implications for the clinical management of snoring children, who may require treatment at an earlier age to prevent poor blood vessel health and an increased risk of cardiovascular diseases later in life.Read moreRead less
Metabolic Complications Of Obstructive Sleep Apnea During Early Development
Funder
National Health and Medical Research Council
Funding Amount
$320,375.00
Summary
Adults with OSA are known to have increased risk for heart disease. We will study children with OSA, and an animal model of the disease during early development, to help clarify how this disease of adulthood actually has its origins in childhood. We have already shown that obese children with obstructive sleep apnea (OSA) are more prone to diabetes (metabolic problems) than those without OSA. More recently, we found that this is also true for children who are not overweight. This early diabetes ....Adults with OSA are known to have increased risk for heart disease. We will study children with OSA, and an animal model of the disease during early development, to help clarify how this disease of adulthood actually has its origins in childhood. We have already shown that obese children with obstructive sleep apnea (OSA) are more prone to diabetes (metabolic problems) than those without OSA. More recently, we found that this is also true for children who are not overweight. This early diabetes is known to be to show a future risk for heart disease. This study will examine why OSA in children is linked to metabolic problems. First, we will continue our study in children who are not overweight. We need to study more children to be sure that OSA is truly linked to metabolic problems - whether or not a child is overweight, because this means that children with OSA are at risk for metabolic and future cardiac problems, whether they are overweight or not. Since weight does not usually change after treatment of OSA, we will also study children again, after they have been treated for OSA. We expect to show that treatment of OSA resolves the metabolic problems. Since hypoxia (low oxygen) occurs in OSA we believe that this is the fundamental cause of the metabolic problems. To test whether this is true, we will look for metabolic problems in piglets exposed to similar, low levels of oxygen as those seen in children with OSA, comparing them to piglets that have not been so exposed. We believe that the tendency to develop OSA and diabetes is inherited. To test this, we will study the genes of a very large family whose members have OSA and-or diabetes, and try to find which genes are associated with OSA and with diabetes. This will help determine if the two genes are linked in some way.Read moreRead less
Sleep Disordered Breathing And Neurocognitive Function In Children Post-adenotonsillectomy: Three Year Follow-up
Funder
National Health and Medical Research Council
Funding Amount
$266,536.00
Summary
Snoring is very common and affects at least 10% of children, or an estimated 0.25 million children in Australia. It is associated with deficits in a wide range of neurocognitive areas including intelligence, memory, reasoning, learning and behaviour. We have recently studied a group of 53 snoring children both before and six months after removal of their tonsils and adenoids, to treat suspected upper airway obstruction associated with their snoring. We found that prior to surgery, intelligence, ....Snoring is very common and affects at least 10% of children, or an estimated 0.25 million children in Australia. It is associated with deficits in a wide range of neurocognitive areas including intelligence, memory, reasoning, learning and behaviour. We have recently studied a group of 53 snoring children both before and six months after removal of their tonsils and adenoids, to treat suspected upper airway obstruction associated with their snoring. We found that prior to surgery, intelligence, memory, reasoning, language and behaviour were significantly reduced, by up to 10% compared to 53 non-snoring control children matched by age, gender, social class and area of residence. To our great surprise, at six months after surgery we found that although sleep and behaviour improves, intelligence, memory, reasoning and language development do not. We now wish to study these same children at 3 years after tonsils and adenoids removal, as we believe that if the deficits that we described at 6 months are still present, they are likely now to be permanent. Given the degree of deficit that we have found in snoring compared to non-snoring children, even 6 months after the snoring group of children have been treated, if still present at 3 years post-surgery then it is likely that these deficits will affect the children's future learning potential and academic success. In turn, this would suggest that early identification and treatment of sleep-related upper airway obstruction is critical in preventing long-term deficits in children's daytime functioning and behaviour.Read moreRead less