Tidal Volume Single Breath Washout of Two Tracer Gases - A Practical and Promising Lung Function Test

Small airway disease frequently occurs in chronic lung diseases and may cause ventilation inhomogeneity (VI), which can be assessed by washout tests of inert tracer gas. Using two tracer gases with unequal molar mass (MM) and diffusivity increases specificity for VI in different lung zones. Currently washout tests are underutilised due to the time and effort required for measurements. The aim of this study was to develop and validate a simple technique for a new tidal single breath washout test (SBW) of sulfur hexafluoride (SF(6)) and helium (He) using an ultrasonic flowmeter (USFM)

Snoring and its association with asthma in Indigenous children living in the Torres Strait and Northern Peninsula Area

Objective: Respiratory health of Indigenous and minority ethnic groups in affluent countries is poorer than their non-minority counterparts and sleep disorders are no exception. In children, obstructive sleep apnoea has the potential to result in serious long-term consequences. In 1999, we studied 1650 children and adolescents living in the Torres Strait and the Northern Peninsula Area, Australia. Here we report prevalence of snoring in these communities and relate its association with asthma symptoms. Methods: A population-based cross-sectional study was conducted in the Torres Strait region. Five indigenous communities were randomly selected and information was collected using a structured face-to-face interview based on a standardized questionnaire. There was a 98% response rate, and 1650 children, 0-17 years of age, were included in the study. Results: Overall, the prevalence of snoring was 14.2% (95% CI 12.5-15.9); 3.6% (95% CI 2.7-4.6) reported snorting, and 6% (95% CI 4.9-7.2) reported restless sleep. The prevalence of snoring was significantly higher among males (17.1% for males and 10.8 for females, P = 0.005). Children were five times more likely to have experienced snoring and snorting if they reported wheezing in the last 12 months. Conclusion: We conclude that the prevalence of symptoms suggestive of obstructive sleep problems is relatively high in children of this region. This highlights the need for awareness among the community patients and physicians about the problem of obstructive sleep-disordered breathing, especially in children with asthma, and for the need for further studies to measure prevalence of sleep breathing disorders among Indigenous Australians

Early life environment and snoring in adulthood.

Background: To our knowledge, no studies of the possible association of early life environment with snoring in adulthood have been published. We aimed to investigate whether early life environment is associated with snoring later in life.  Methods: A questionnaire including snoring frequency in adulthood and environmental factors in early life was obtained from 16,190 randomly selected men and women, aged 25-54 years, in Sweden, Norway, Iceland, Denmark and Estonia (response rate 74%).  Results: A total of 15,556 subjects answered the questions on snoring. Habitual snoring, defined as loud and disturbing snoring at least 3 nights a week, was reported by 18%. Being hospitalized for a respiratory infection before the age of two years (adjusted odds ratio (OR) = 1.27; 95% confidence interval (CI) 1.01-1.59), suffering from recurrent otitis as a child (OR = 1.18; 95% CI 1.05-1.33), growing up in a large family (OR = 1.04; 95% CI 1.002-1.07) and being exposed to a dog at home as a newborn (OR = 1.26; 95% CI 1.12-1.42) were independently related to snoring later in life and independent of a number of possible confounders in adulthood. The same childhood environmental factors except household size were also related with snoring and daytime sleepiness combined.  Conclusion: The predisposition for adult snoring may be partly established early in life. Having had severe airway infections or recurrent otitis in childhood, being exposed to a dog as a newborn and growing up in a large family are environmental factors associated with snoring in adulthood

Symptoms of sleep breathing disorders in children are underreported by parents at general practice visits

The original publication is available at www.springerlink.comSleep breathing disorders (SBD) in children are reportedly underdiagnosed in general practice. A contributory factor may be parental underreporting of symptoms. This possibility was examined by comparing the frequency with which snoring was mentioned at general practitioner visits by parents with frequency that snoring was reported on questionnaire evaluation immediately prior to consultation. We also examined the effects of age and gender on SBD symptoms. Parents of 626 children aged 0 to 16 years attending their general practitioner for sick child visits completed selected items from the Sleep Disturbance Scale for Children and the Obstructive Sleep Apnea Syndrome Expanded Childhood Questionnaire. Parents and general practitioners were also asked if snoring was discussed at the current consultation visit or at a prior consultation visit in the previous 12 months. Eighteen percent (112 of 626) of children were frequent snorers (more than three times per week), whereas 0.6 to 5.0% of children snored and had one or more additional SBD symptom suggestive of obstructive sleep apnea. SBD symptoms tended to peak in early to middle childhood with few gender differences. We found that snoring was patently underreported by parents. In the children with a history of frequent snoring on questionnaire evaluation and where the reason for the consultation visit was documented, snoring was mentioned by parents at the current consultation visit in only 8% (8 of 100) of cases and at a prior consultation visit in only 15% (15 of 100) of cases. The present findings support a need for increased parental education regarding the symptoms and clinical significance of SBD.Sarah Blunden, Kurt Lushington, Berndt Lorenzen, Johnny Wong, R. Balendran and Declan Kenned