Sleep Symptoms and Polysomnographic Patterns of Obstructive Sleep Apnea in Obese Children

How to Cite This Article: Tavasoli A, Jalilolghadr Sh, Lotfi Sh. Sleep symptoms and polysomnographic patterns of obstructive sleep apnea in obese children. Iran J Child Neurol. Winter 2016; 10 (1):14-20.AbstractObjectiveThis study was conducted to investigate the sleep symptoms and polysomnographic patterns of obstructive sleep apnea in overweight and obese children.Materials & MethodsOverweight or obese children aging 6-18 yr old referred during 2010 to Endocrinology Clinic of Ghods Hospital in Ghazvin, central Iran were enrolled in the study. Polysomnography was done for the diagnosis of obstructive sleep apnea and the BEARS and Children’s Sleep Habits questionnaires were used to survey sleep behaviors.ResultsWe enrolled 30 children (14 males, 16 females). Twenty-one cases had body mass index (BMI) >95% and 9 had 85% <BMI<95%. Respiratory disturbance in polysomnography was seen in 90% of cases. Symptoms included snoring 18 (60%); frequent awakening 17 (56.6%); nocturnal sweating 15 (50%); daytime sleepiness 12 (40%); sleep talking 10 (33.3%); bedtime resistance 9 (30%); nightmares 8 (26.6%); waking up problems 6 (20%); sleep walking 6 (20%); difficult breathing 4 (13.3%); bedwetting 3 (10%) and sleep onset delay 2 (6.06%). Severe, moderate and mild apnea – hypopnea Index (AHI) were seen in 12, 9 and 6 subjects, respectively. A significant Pearson correlation was found between the BMI values and sleep latency.ConclusionPrevalence of obstructive sleep apnea is high among overweight and obese children. Physicians should be familiar with its manifestations and consider polysomnography as an invaluable diagnostic test. There was no relation between the degree of obesity and severity of obstructive sleep apnea

The Effects of Melatonin Treatment on Chronic Insomnia in 1–3-Year-Old Children Undergoing Behavior Therapy

Background: Melatonin is effective as a treatment option for sleep disorders in children. Parents can develop positive sleep habits in children through behavior therapy. This study aimed to evaluate the effects of melatonin on children undergoing behavioral therapy. Method: The present study was performed on 60 children (1–3-year-old, male and female). Thirty children were randomly selected as the treatment group, treated with melatonin. All of the participants in both treatment and control groups and their parents were taught how to observe sleep hygiene and behavior therapy through a graduated extinction method. The Pediatric Sleep Clinic Questionnaire Background Information (for 1–3-year-old children) was used in this research. Parents in both groups were educated on sleep hygiene and behavioral therapy. The data was analyzed through paired t-test and chi-square (p < 0.05) using SPSS 18 software program. Result: Mean ± SD (standard deviation) of age was 27.33 ± 8.99 months in the behavior therapy/melatonin-treated group, while it was 23.10 ± 10.76 months in the behavior therapy/non-melatonin-treated group. There was a significant difference between the two groups regarding breastfeeding (p <0.05). Moreover, significant differences were observed between the two groups in terms of the average number of waking ups during the night, the length of wakefulness of a child at night (in minutes), the time of waking up in the morning, the average sleep time at night (in hours), and the relationship between sleeping in parents’ bed and parents staying in the child’s room after the lights were switched off (p <0.05). Conclusion: The quality of night sleep in the melatonin-treated group was better than that in the group that did not receive melatonin. Therefore, proper medical treatment along with psychological and behavioral therapies can be helpful for treating sleep disorder

Prevalence of Metabolic Syndrome and Insulin Resistance in Children and Adolescent of Qazvin, Iran

BACKGROUND: The prevalence of metabolic syndrome (MetSyn) is increasing worldwide. The aim of this study was to determine the prevalence of MetSyn and insulin resistance (IR) in children and adolescents in Qazvin, Iran. METHODS: A cross-sectional study was conducted in 338 children and adolescents aged 10–18 years old who were selected by a multistage cluster random sampling method. We performed standardised measurements of variables including waist circumference (WC), blood pressure, plasma glucose level, total cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, and insulin. MetSyn was defined according to the International Diabetes Federation criteria. IR was estimated by the homeostatic model assessment. RESULTS: Of the 338 total subjects, 172 were female. The overall prevalence of MetSyn and IR were 3.4% and 18.2%, respectively. There was no sex difference for the prevalence of MetSyn. A total of 185 subjects (56.4%) had one or two components of MetSyn. The most common component was low HDL levels in both sexes, which was followed by high WC in females and high fasting plasma glucose levels in males. CONCLUSION: The lack of a standard definition of MetSyn in children and adolescents combined with the geographical and socioeconomic differences make it difficult to compare the results from different studies. Modification of lifestyle habits is an important strategy in preventing MetSyn and IR

Polysomnography findings of patients with overlap syndrome according to severity of lower airway obstruction

Background: The concurrence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome (OS). The obstruction of the upper airway leads to OSA and the obstruction of the lower airway leads to COPD. The aim of this study was to compare polysomnographic findings of patients with OS according to severity of lower airway obstruction. Materials and Methods: Seventy‑two patients were included in this cross‑sectional study. Patients with COPD referred to a sleep clinic with suspicion of OSA were evaluated by polysomnography (PSG). PSG findings were interpreted based on the American Academy of Sleep Association criteria (2012). COPD severity was categorized into four groups based on GOLD criteria using forced expiratory volume in the first second (FEV1). PSG findings also were compared between patients regarding severity of lower airway obstruction (FEV1 ≥50% and FEV1 <50%). Results: Sixty‑eight of the patients had OS. Twenty‑nine (42.6%) were male. The mean age was 62.3 پ} 6.88 years. Thirty‑two (54.4%) of the patients were in GOLD 2. The mean apnea/hypopnea index was 57.41 پ} 36.16. Seventy‑two percent of patients had severe OSA. Severe OSA was more prevalent in patients of GOLD 2 and 3 groups compared to the other groups. Among PSG findings, only N2 sleep stage was significantly longer in patients with FEV1 < 50% than in patients with FEV1 ≥50% (61.5 پ} 11.2, 55.3 13.4, P = 0.039). Conclusion: Polysomnographic findings (except N2 stage) are not different in patients with OS with respect to severity of lower airway obstruction. Key words: Chronic obstructive pulmonary disease, overlap syndrome, polysomnography, sleep apne

Correlation between food habits and time spent watching television with sleep quality at children and teenagers, MINOODAR Qazvin

Introduction: Children from the age of each person's life so that people's eating habits are formed during this period. Some studies of the relationship between TV viewing time and also how sleep quality and eating habits in children and adolescents are supported, but others do not approve of the presence of such a relationship. This study aimed to investigate the association between dietary habits and TV viewing time sleep quality in children and adolescents 10-18 years Minoodar Qazvin. Materials and methods: The study population of 10-18 year old population research center was MINOODAR. Sampling using multi-stage cluster random sampling was performed. All demographic, anthropometric and nutrition, as well as questions related to sleep quality standard questionnaire and was collected by trained personnel. Data were analyzed using spss softwareversion16. Findings: Most of the adolescents studied food groups: grains, meat and oil more than the recommended but milk and dairy product and vegetable group were receiving less than the recommended amount. The results showed that boys compared with girls, bread and cereals (p=0/005) and milk and milk products (p=0/048) received more. Also, people who had low sleep quality was higher consumption of bread and cereals (p= 0/01). People with normal sleep omega-3 fatty acids consumed more (p<0/05). The regression analysis of sleep quality with age, gender, time of watching TV, playing video games and get the time of caffeine was no observed. Conclusions: The nutritional status of adolescents in need of reform. This study showed that eating less bread and refined grains and omega-3 fatty acid intake may increase sleep quality in children and adolescents are more boys than girls drank milk and dairy products, so the problem of delay sleep and irregular sleep was less. Also watching TV for 2 hours a day will have no effect on quality of sleep, however, to verify the results of this study, further research is needed in this area

Sleep duration and its relationship with school performance in Iranian adolescents

Background. Inadequate or poor sleep quality is common problems in adolescent that affect on their learning, memory and school performance. The present study aimed to determine the association between sleep hours and academic performance in young adults. Methods. This cross-sectional study was designed as a descriptive-analytic study. Samples of adolescents of 14-18 years old in Qazvin city were enrolled. The Pediatric sleep questionnaire and BEARS questionnaire used for all students to screen comprehensively major sleeps problems in them. Chi-square test, t-test, analysis of variance (ANOVA), and correlation were performed to determine the relationship between the data (P < 0.001). Results. Between 653 adolescents, 40% were male and 60% were female. Sleep duration, sleep onset delay, sleep insufficient, rate of oversleeping and academic performance had a direct relationship with gender (P < 0.001). The sleep duration, rate of oversleeping and academic performance were significantly higher in boys, sleep onset delay and sleep insufficient was significantly higher in girls. Time of falling sleep at weekend nights and weekday nights have positively correlation with age (P < 0.001). Also, a significant relationship between students’ sleep hours with academic performance was shown (P < 0.001). Conclusions. The overall result was that sleep duration, sleep onset delay, sleep insufficient and rate of oversleeping of students in this study had a significant influence on academic performance. Students without difficulty in falling asleep had good academic performance in compared to students with difficulty in falling asleep