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1.
Sleep Med ; 76: 48-54, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33091726

RESUMO

OBJECTIVES: To evaluate sleep duration in a representative sample of preschoolers and examine the relationships between screen time and use of different electronic media devices with sleep duration and social jetlag. METHODS: 2903 preschoolers were included. Parent-completed questionnaire provided information on socioeconomic status, electronic media use of the children and sleep patterns of both parents and children. Preschoolers were divided according to whether they met the international screen time recommendations for their age. Comparisons between the two groups in various sleep measures and effects of different devices on sleep were evaluated. RESULTS: 40% of preschoolers in our cohort did not achieve the recommended sleep duration. Subjects who adhered to the screen time recommendations were from families of higher socioeconomic status, had longer sleep duration and better sleep habits. Each hour increase on portable electronic device use was associated with 11 (95%CI: -15 to -6) and 6 (95%CI: -10 to -2) minutes less of average daily sleep duration in boys and girls, respectively. Every additional hour of non-portable electronic devices use was associated with 3 min shift in social jetlag in boys. Presence of electronic devices in bedroom and their use at bedtime increased risk of social jetlag in boys with an OR of 1.40 (95%CI: 1.01 to 1.92) and 1.39 (95%CI: 1.00 to 1.95) respectively. CONCLUSION: A significant proportion of preschoolers does not obtain the recommended amount of sleep. Screen time in preschoolers affects not only sleep duration but also leads to circadian discrepancy.

2.
Chest ; 156(1): 120-130, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30922948

RESUMO

BACKGROUND: Understanding the natural history of childhood OSA can help to determine disease prognosis and to guide risk stratification and management strategies. METHODS: To evaluate the natural history of childhood OSA and factors associated with spontaneous remission and persistent and incident OSA from childhood to late adolescence/early adulthood, a longitudinal analysis of a prospective community-based cohort was designed. Subjects from a cohort established for an OSA prevalence study were invited to participate in this 10-year follow-up study. RESULTS: Two hundred and forty-three participants (59% male) took part, and their mean age was 9.8 (SD, ± 1.8) and 20.2 (SD, ± 1.9) years at baseline and follow-up, respectively. The mean follow-up duration was 10.4 (SD, ± 1.1) years. Associations between baseline and follow-up log-transformed obstructive apnea-hypopnea index (OAHI) differed by age; a significant positive association was observed only among participants aged 10 years or older at baseline. Overall polysomnographic remission rate (with OAHI < 1 event/h at follow-up) of childhood OSA was 30%, and 69% had an OAHI < 5 events/h at follow-up. Complete remission of OSA was associated with female sex. Incidence of adolescent/adult OSA with an OAHI ≥ 5 events/h at follow-up was 22%. Male sex and higher baseline BMI z score were associated with incident OSA. CONCLUSIONS: A proportion of children with OSA, particularly female children, had complete resolution during transition to late adolescence or early adulthood. Childhood and adolescent OSA are distinct entities, with the latter more likely to persist into adulthood. Obesity and male sex are consistent key risk factors for incident OSA.


Assuntos
Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Adolescente , Fatores Etários , Criança , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Obesidade/complicações , Polissonografia , Prognóstico , Estudos Prospectivos , Remissão Espontânea , Medição de Risco , Fatores Sexuais , Adulto Jovem
3.
PLoS One ; 14(3): e0213674, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30861055

RESUMO

OBJECTIVE: To investigate scaling approaches for evaluating the development of peak VO2 and improving the identification of low cardiopulmonary fitness in Southern Chinese children and adolescents. METHODS: Nine hundred and twenty Chinese children and adolescents (8 to 16 years) underwent graded cardiopulmonary exercise test on a treadmill until volitional exhaustion. Peak VO2 was corrected for the effects of body mass by ratio or allometric scaling. Z score equations for predicting peak VO2 were developed. Correlations between scaled peak VO2, z scores, body size and age were tested to examine the effectiveness of the approach. RESULTS: Eight hundred and fifty-two participants (48% male) were included in the analyses. Absolute peak VO2 significantly increased with age in both sexes (both P<0.05), while ratio-scaled peak VO2 increased only in males (P<0.05). Allometrically scaled peak VO2 increased from 11 years in both sexes, plateauing by 12 years in girls and continuing to rise until 15 years in boys. Allometically scaled peak VO2 was not correlated with body mass, but remained correlated with height and age in all but the older girls. Peak VO2 z score was not correlated with body mass, height or age. CONCLUSIONS: Absolute and allometric scaled peak VO2 values are provided for Hong Kong Chinese children and adolescents by age and sex. Peak VO2 z scores improve the evaluation of cardiopulmonary fitness, allowing comparisons across ages and sex and will likely provide a better metric for tracking change over time in children and adolescents, regardless of body size and age.


Assuntos
Aptidão Cardiorrespiratória , Teste de Esforço/normas , Exercício Físico , Consumo de Oxigênio , Adolescente , Fatores Etários , Antropometria , Grupo com Ancestrais do Continente Asiático , Tamanho Corporal , Peso Corporal , Criança , China , Feminino , Hong Kong , Humanos , Masculino , Valores de Referência , Sistema Respiratório
4.
Sleep Med ; 16(3): 358-63, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25650159

RESUMO

BACKGROUND: The use of non-surgical treatment for childhood obstructive sleep apnea (OSA) is gaining popularity, especially in children with mild disease. OBJECTIVE: To test the hypothesis that intranasal corticosteroids reduce disease severity in children with mild OSA. STUDY DESIGN: A randomized, double-blinded, placebo-controlled trial of intranasal mometasone furoate (MF) versus placebo in children aged 6 to 18 years with mild OSA. The primary outcome was the change from baseline obstructive apnea hypopnea index (OAHI), as documented by overnight polysomnography, after four months of treatment. RESULTS: Sixty-two children were recruited but 12 dropped out. This left 24 and 26 children for final analysis in the MF and placebo group, respectively. The OAHI and oxygen desaturation index (ODI) improved significantly in the MF group only. The OAHI decreased from 2.7 ± 0.2 to 1.7 ± 0.3 in the MF group, but increased from 2.5 ± 0.2 to 2.9 ± 0.6 in the placebo group (p = 0.039). The mean changes in ODI in the MF group and placebo group were -0.6 ± 0.5 and +0.7 ± 0.4, respectively (p = 0.037). CONCLUSION: Four months of treatment with intranasal mometasone furoate effectively reduces the severity of mild OSA in children.


Assuntos
Anti-Inflamatórios/administração & dosagem , Furoato de Mometasona/administração & dosagem , Apneia Obstrutiva do Sono/tratamento farmacológico , Tonsila Faríngea/patologia , Administração Intranasal , Adolescente , Criança , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Masculino , Tonsila Palatina/patologia , Polissonografia , Apneia Obstrutiva do Sono/patologia , Resultado do Tratamento
5.
Pediatr Pulmonol ; 50(6): 535-43, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24891337

RESUMO

While several randomized control trials (RCTs) have evaluated the use of fractional exhaled nitric oxide (FeNO) to improve asthma outcomes, none used FeNO cut-offs adjusted for atopy, a determinant of FeNO levels. In a dual center RCT, we assessed whether a treatment strategy based on FeNO levels, adjusted for atopy, reduces asthma exacerbations compared with the symptoms-based management (controls). Children with asthma from hospital clinics of two hospitals were randomly allocated to receive an a-priori determined treatment hierarchy based on symptoms or FeNO levels. There was a 2-week run-in period and they were then reviewed 10 times over 12-months. The primary outcome was the number of children with exacerbations over 12-months. Sixty-three children were randomized (FeNO = 31, controls = 32); 55 (86%) completed the study. Although we did achieve our planned sample size, significantly fewer children in the FeNO group (6 of 27) had an asthma exacerbation compared to controls (15 of 28), P = 0.021; number to treat for benefit = 4 (95% CI 3-24). There was no difference between groups for any secondary outcomes (quality of life, symptoms, FEV1 ). The final daily inhaled corticosteroids (ICS) dose was significantly (P = 0.037) higher in the FeNO group (median 400 µg, IQR 250-600) compared to the controls (200, IQR100-400). Taking atopy into account when using FeNO to tailor asthma medications is likely beneficial in reducing the number of children with severe exacerbations at the expense of increased ICS use. However, the strategy is unlikely beneficial for improving asthma control. A larger study is required to confirm or refute our findings.


Assuntos
Asma/tratamento farmacológico , Broncodilatadores/uso terapêutico , Budesonida/uso terapêutico , Fluticasona/uso terapêutico , Óxido Nítrico/análise , Adolescente , Asma/diagnóstico , Testes Respiratórios , Broncodilatadores/administração & dosagem , Criança , Pré-Escolar , Expiração , Feminino , Humanos , Masculino , Qualidade de Vida , Resultado do Tratamento
6.
Chest ; 147(1): 132-139, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25275798

RESUMO

BACKGROUND: The association between childhood OSA and endothelial function as measured by flow-mediated dilation (FMD) and its response to OSA treatment are uncertain. The objective of this study was to compare FMD in children with OSA with nonsnoring control subjects and to examine its response to treatment. METHODS: Index cases were children aged 6 to 18 years with habitual snoring and polysomnography (PSG)-confirmed OSA (obstructive apnea hypopnea index [OAHI] > 1 events/h). Each case was paired with an age-, sex-, and BMI-matched nonsnoring control subject recruited from our previous community growth survey. All subjects underwent FMD measurement in the morning after overnight PSG. Adenotonsillectomy (AT) was offered to subjects who satisfied predefined AT operation criteria. All cases underwent repeat PSG and FMD assessment 6 months later. RESULTS: A total of 63 case-control pairs were recruited. The OSA group had a significantly higher OAHI (median, 5.3 events/h [interquartile range (IQR), 2.6-11.7] vs 0.2 events/h [IQR, 0-0.5], P < .001) and lower FMD (mean ± SD, 7.9% ± 1.3% vs 8.3% ± 0.8%; P = .04) than the control group. Thirty-two case subjects underwent AT. A significant reduction in OAHI was documented in the AT group (-8.8 events/h [IQR, -13.7 to -4.7]; P < .001) accompanied by a significant increase in FMD (+0.6% [IQR, 0.4-1.4]; P < .001), which was not observed in subjects who did not undergo AT. CONCLUSIONS: Children with OSA had reduced FMD, which was reversible with treatment.


Assuntos
Adenoidectomia , Endotélio Vascular/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia , Tonsilectomia , Vasodilatação/fisiologia , Adolescente , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/fisiopatologia , Criança , Feminino , Seguimentos , Humanos , Masculino , Polissonografia , Apneia Obstrutiva do Sono/cirurgia , Ultrassonografia
7.
Saf Health Work ; 6(3): 192-9, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26929827

RESUMO

BACKGROUND: Overweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters in Hong Kong. METHODS: Male firefighters (n = 387) were randomly selected from serving firefighters in Hong Kong (n = 5,370) for the assessment of cardiovascular disease risk factors (obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, known cardiovascular diseases). One-third (Target Group) were randomly selected for the assessment of off-duty leisure-time physical activity using the short version of the International Physical Activity Questionnaire. Maximal oxygen uptake was assessed, as well as cardiovascular workload using heart rate monitoring for each firefighter for four "normal" 24-hour working shifts and during real-situation simulated scenarios. RESULTS: Overall, 33.9% of the firefighters had at least two cardiovascular disease risk factors. In the Target Group, firefighters who had higher leisure-time physical activity had a lower resting heart rate and a lower average working heart rate, and spent a smaller proportion of time working at a moderate-intensity cardiovascular workload. Firefighters who had moderate aerobic fitness and high leisure-time physical activity had a lower peak working heart rate during the mountain rescue scenario compared with firefighters who had low leisure-time physical activities. CONCLUSION: Leisure-time physical activity conferred significant benefits during job tasks of moderate cardiovascular workload in firefighters in Hong Kong.

8.
Chest ; 145(6): 1255-1263, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24384690

RESUMO

BACKGROUND: Childhood OSA is a prevalent condition associated with raised BP as documented in cross-sectional studies. This study aimed to determine whether baseline or change in OSA severity was associated with ambulatory BP at 4-year follow-up. METHODS: Children who participated in our previous OSA prevalence research were invited to undergo a repeat overnight sleep study and 24-h ambulatory BP monitoring in this 4-year follow-up study. BP parameters of subjects with differing baseline OSA severity, that is, obstructive apnea-hypopnea index (OAHI) < 1/h, 1 to 5/h, and > 5/h, were compared. Overweight and normal-weight children were analyzed separately. RESULTS: One hundred eighty-five of 306 subjects (60%) were included in the analysis, of whom 58 were overweight at baseline. Linear increasing trends of wake systolic BP (SBP), wake diastolic BP (DBP), and sleep SBP z scores at follow-up were found across groups of increasing baseline OSA severity in the normal weight but not in the overweight subgroup. After adjusting for BMI z score, baseline OAHI was independently associated with all BP z scores at follow-up but not associated with changes in BP z scores across 4 years. On the other hand, change in OAHI was independently associated with sleep SBP and DBP z scores at follow-up and with changes in sleep SBP and DBP z scores across 4 years. CONCLUSIONS: This study provides longitudinal data as additional proof that childhood OSA is associated with elevated BP independent of obesity.


Assuntos
Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia , Adolescente , Monitorização Ambulatorial da Pressão Arterial , Criança , Ritmo Circadiano/fisiologia , Comorbidade , Feminino , Seguimentos , Hong Kong , Humanos , Estudos Longitudinais , Masculino , Obesidade/fisiopatologia , Polissonografia , Estudos Prospectivos , Índice de Gravidade de Doença
9.
J Paediatr Child Health ; 49(11): 969-75, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23735004

RESUMO

AIM: To investigate the effect of orlistat on endothelial function in obese adolescents. METHODS: Single-blind 10-week controlled trial of 67 normolipidaemic obese adolescents randomised into three groups. Group 1 (diet alone), Group 2 (diet and orlistat), Group 3 (diet, orlistat and exercise). Endothelial function measured by flow-mediated dilatation (FMD) of the brachial artery, anthropometric parameters, blood pressure, fasting blood lipids, insulin and glucose levels were recorded at baseline and at 10 weeks. RESULTS: Sixty four subjects completed the study. Groups were comparable at baseline. FMD increased significantly with orlistat (Groups 2 and 3) but not in Group 1. Orlistat treatment resulted in significantly reduced bodyweight, body mass index (BMI), waist circumference, total and low-density lipoprotein (LDL) cholesterol levels. High-density lipoprotein cholesterol levels were unchanged. Triglyceride and insulin levels were significantly reduced in all three groups. The reduction in cholesterols did not correlate with reductions in weight and BMI. A slight reduction of body fat, both with and without orlistat treatment, correlated with reduction in BMI after adjustment for baseline values. Blood pressure was unaltered by orlistat. Calorie intake was reduced with orlistat, and the decrease noted in % fat and increase in % carbohydrate was significant only in those taking orlistat. The addition of exercise (Group 3 compared with Group 2) altered no parameter. CONCLUSIONS: Orlistat improves endothelial function and reduces bodyweight, BMI, fasting total and LDL-cholesterol in obese adolescents when combined with dietary control. Improvement in endothelial function if maintained could reflect long-term cardiovascular benefit.


Assuntos
Fármacos Antiobesidade/farmacologia , Células Endoteliais/efeitos dos fármacos , Lactonas/farmacologia , Obesidade/tratamento farmacológico , Adolescente , Antropometria , Determinação da Pressão Arterial , Criança , Ingestão de Energia , Jejum/sangue , Feminino , Hong Kong , Humanos , Masculino , Atividade Motora , Obesidade/dietoterapia , Orlistate
10.
J Paediatr Child Health ; 49(2): E153-9, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23331463

RESUMO

AIMS: To evaluate: (i) the prevalence of habitual snoring (HS) in a large sample of children aged from birth to 36 months in 14 countries across Asia Pacific; and (ii) the different correlates associated with HS in Caucasians, Chinese and non-Chinese, non-Caucasian Asians. METHODS: This was a multi-centre, cross-sectional survey conducted across Asia Pacific. Parents/caregivers of 23,481 infants and toddlers completed an expanded version of the Brief Infant Sleep Questionnaire. We defined HS as snoring more than three nights per week. RESULTS: Chinese and non-Caucasian non-Chinese (NCNC) children had a lower prevalence of HS across the age range from birth to 3 years than their Caucasian counterparts (6.2% and 5.1% vs. 11%, P < 0.01). Boys had a higher prevalence of HS compared to girls (χ(2) = 98.5, P < 0.0001). History of prematurity (OR = 1.37-1.56, CI (1.1-2.17), P < 0.01) and gender (OR = 1.53-1.54, CI (1.26-1.85), P < 0.0001) were found to be significant predictors for HS. Current breastfeeding (OR = 0.69, CI (0.54-0.88), P < 0.005) and greater parental age (OR = 0.86, CI (0.78-0.96), P < 0.01) were protective against HS among NCNC children. HS was less prevalent in younger Chinese subjects (OR = 0.88, CI (0.84-0.93), P < 0.0001). In Caucasians, parents' education (OR = 0.78, CI (0.67-0.91), P < 0.005) and their not sleeping in the same room as their child (OR = 0.62, CI (0.45-0.86), P < 0.005) were negatively associated with parental report of HS. CONCLUSIONS: Prevalence of HS shows racial differences among countries across Asia Pacific. Future studies should assess craniofacial structure and body fat distribution as contributory factors for this differential prevalence.


Assuntos
Ronco/epidemiologia , Pré-Escolar , Intervalos de Confiança , Estudos Transversais , Extremo Oriente/epidemiologia , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Inquéritos e Questionários
11.
Int J Cardiol ; 167(5): 2092-6, 2013 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-22703940

RESUMO

BACKGROUND: Sleep disordered breathing, especially obstructive sleep apnea, is associated with endothelial dysfunction in both adults and children. However, the role of primary snoring (PS) on endothelial function has not been investigated. This study aimed to examine flow-mediated vasodilation (FMD) in both normal weight and overweight children with PS. METHODS: Children aged 6-18 years with habitual snoring were recruited from our sleep disorder clinic. Non-snoring controls were recruited from participants of a community growth survey. All subjects underwent polysomnography and FMD evaluation on the same day. Children with body mass index of greater than the 85th percentile of the local reference were defined as overweight. Subjects were divided into groups of normal weight, overweight, non-snorers and PS for comparisons. RESULTS: Two hundred and one children, of whom 83 were overweight, with a mean ± SD age of 11.3 ± 2.7 years were recruited. Seventy three out of 201 children had PS. Both normal weight (7.9 ± 1.3 vs. 8.5 ± 0.9, p=0.012) and overweight subjects (7.4 ± 1.4 vs. 8.1 ± 1.1, p=0.006) with PS had significantly reduced FMD than the non-snoring controls. Multivariate linear regression model showed that PS was independently associated with reduced FMD in both normal weight (p=0.014) and overweight subgroups (p=0.016) after controlling for obstructive apnea hypopnea index. CONCLUSIONS: PS in children is associated with reduced FMD, independent of obesity.


Assuntos
Artéria Braquial/fisiologia , Polissonografia/métodos , Ronco/diagnóstico , Ronco/fisiopatologia , Vasodilatação/fisiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/fisiopatologia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia
12.
Chest ; 143(3): 729-735, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23099418

RESUMO

BACKGROUND: The objective of this study was to examine the natural history of childhood primary snoring (PS) and to identify predictive clinical symptoms and risk factors associated with PS progression to obstructive sleep apnea (OSA). METHODS: Children aged 6 to 13 years old who received a diagnosis of PS in our previous community-based OSA prevalence study were invited to undergo repeat polysomnography (PSG) at 4-year follow-up. Subjects with an obstructive apnea hypopnea index (OAHI) ≥ 1 were classified as having OSA at follow-up. RESULTS: Seventy children (60% boys) with a mean age of 14.7 ± 1.8 years were analyzed in this follow-up study. The mean duration of follow-up was 4.6 ± 0.6 years. At follow-up, 26 subjects (37.1%) progressed to OSA, of whom five (7.1%) had moderate to severe disease (OAHI ≥ 5). Twenty-two (31.4%) remained at PS, and 18 (25.7%) had complete resolution of their snoring with normal PSG. Persistent snoring had a positive predictive value of 47.7% and a negative predictive value of 86.4% for progression from PS to OSA. Multivariate logistic regression analysis showed that persistent overweight/obesity was a significant risk factor for the development of OSA at follow-up, with an OR of 7.95 (95% CI, 1.43-44.09). CONCLUSIONS: More than one-third of school-aged children with PS progressed to OSA over a 4-year period, although only 7.1% developed moderate to severe disease. Weight control may be an important component in the management of PS because obesity was found to be a significant risk factor for PS progression.


Assuntos
Apneia Obstrutiva do Sono/epidemiologia , Ronco/epidemiologia , Adolescente , Criança , Progressão da Doença , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Sobrepeso/epidemiologia , Polissonografia , Valor Preditivo dos Testes , Fatores de Risco , Síndromes da Apneia do Sono
13.
Respirology ; 17(3): 513-8, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22212464

RESUMO

BACKGROUND AND OBJECTIVE: The aim of this study was to investigate the aerobic capacity of children 3 years after they were diagnosed with severe acute respiratory syndrome (SARS). METHODS: Twenty-seven patients who completed both pulmonary function and maximal aerobic capacity tests at 6 and 15 months after the acute illness were invited to return for reassessment. RESULTS: Twenty-one patients (median age 18.2 years, interquartile range (IQR) 16.5-19.7) completed all investigations at 36 months. Pulmonary function was normal in all patients. Maximal aerobic capacity, peak oxygen pulse (peak VO(2) ) and ventilatory anaerobic threshold showed significant improvements compared with values measured at 6 months in both boys and girls. In girls, ventilatory efficiency (ventilatory equivalents for oxygen and carbon dioxide) and perfusion of the lungs (end-tidal partial carbon dioxide pressure) had not increased further compared with the values measured at 15 months. Although peak VO(2) improved further at 36 months in patients with or without persistent radiological abnormalities, the values were 68% (IQR 50-84) and 74% (IQR 60-99), respectively, of those for normal control subjects. CONCLUSIONS: There were improvements in aerobic capacity at 36 months in children affected by SARS; however, the measured values remained suboptimal.


Assuntos
Exercício Físico/fisiologia , Resistência Física/fisiologia , Síndrome Respiratória Aguda Grave/fisiopatologia , Adolescente , Limiar Anaeróbio/fisiologia , Feminino , Seguimentos , Frequência Cardíaca/fisiologia , Humanos , Pulmão/fisiopatologia , Masculino , Consumo de Oxigênio/fisiologia , Estudos Prospectivos , Testes de Função Respiratória , Adulto Jovem
14.
Arch Dis Child ; 97(5): 470-3, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-21427123

RESUMO

OBJECTIVE: The authors aimed to examine the prevalence and factors associated with night sweats (NS) in primary school children. STUDY DESIGN: Cross-sectional design. RESULTS: Among 6381 children (median age 9.2 (7.7-10.7) years) with complete information on NS, 3225 were boys (50.5%). 747 children (11.7%) were reported to have weekly NS in the past 12 months. Boys were more likely than girls to have NS (p<0.0001). Children with NS were more likely to have sleep-related symptoms and respiratory and atopic diseases. In addition, they were more likely to be hyperactive and have frequent temper outbursts. Using an ordinal regression model, NS was found to be significantly associated with male gender, younger age, allergic rhinitis, tonsillitis and symptoms suggestive of obstructive sleep apnoea, insomnia and parasomnia. CONCLUSION: NS is prevalent among school-aged children and is associated with the presence of sleep-related symptoms and respiratory and atopic diseases.


Assuntos
Transtornos do Sono-Vigília/epidemiologia , Sudorese/fisiologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/fisiopatologia , Estudos Transversais , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Prevalência , Transtornos Respiratórios/epidemiologia , Transtornos Respiratórios/fisiopatologia , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia
15.
J Pediatr ; 159(2): 238-42.e1, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21397910

RESUMO

OBJECTIVES: To examine the prevalence and correlates of nocturnal enuresis (NE) in primary school children, and to compare the prevalence of NE in children with and those without obstructive sleep apnea (OSA). STUDY DESIGN: Parents of children aged 6-11 years completed a questionnaire eliciting information on sleep-related symptoms, demography, and family and past medical history. Children screened due to high risk for OSA, along with a randomly chosen low-risk group, underwent overnight polysomnography (PSG). RESULTS: A total of 6147 children (3032 girls) were studied. The overall prevalence of NE (≥1 wet night/month) was 4.6% (6.7% of boys and 2.5% of girls). Boys had a significantly greater prevalence across all age groups. In 597 children (215 girls) who underwent PSG, the prevalence of NE was not greater in children with OSA, but was increased with increasing severity of OSA in girls only. Boys with NE had longer deep sleep duration. Sex and sleep-related symptoms were associated with NE. CONCLUSIONS: This community-based study demonstrated a sex-associated prevalence of NE in relation to increasing OSA severity.


Assuntos
Enurese Noturna/epidemiologia , Apneia Obstrutiva do Sono/complicações , Criança , Progressão da Doença , Enurese , Feminino , Seguimentos , Hong Kong/epidemiologia , Humanos , Masculino , Enurese Noturna/etiologia , Enurese Noturna/fisiopatologia , Polissonografia , Prevalência , Fatores de Risco , Sono/fisiologia , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Inquéritos e Questionários , Fatores de Tempo
16.
Thorax ; 65(11): 991-7, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20965935

RESUMO

OBJECTIVE: To determine the prevalence and risk factors of obstructive sleep apnoea syndrome (OSAS) in Chinese children using a two-phase community-based study design. METHODS: Children from 13 primary schools were randomly recruited. A validated OSAS screening questionnaire was completed by their parents. Children at high risk of OSAS and a randomly chosen low-risk group were invited to undergo overnight polysomnographic study and clinical examination. The the sex-specific prevalence rate was measured using different cutoffs (obstructive apnoea hypopnoea index ≥ 1, ≥ 1.5, ≥ 3 and ≥ 5 and obstructive apnoea index ≥ 5) and risk factors associated with OSAS were evaluated with logistic regression. RESULTS: 6447 completed questionnaires were returned (out of 9172 questionnaires; 70.3%). 586 children (9.1%; 405 boys and 181 girls) children belonged to the high-risk group. A total of 619 (410 and 209 from the high and low-risk group, respectively) subjects underwent overnight polysomnagraphy. Depending on the cutoffs, the prevalence rate of childhood OSAS varied from 4.8% to 40.3%. Using the International Criteria of Sleep Disorders version II, the OSAS prevalence for boys and girls was 5.8% and 3.8%, respectively. Male gender, body mass index z-score and increased adenoid and tonsil size were independently associated with OSAS. CONCLUSIONS: The prevalence rate of OSAS in children was contingent on the cutoff used. The inclusion of symptoms as a part of the diagnostic criteria greatly reduced the prevalence. A further prospective and outcome study is needed to define a clinically significant diagnostic cutoff for childhood OSAS.


Assuntos
Apneia Obstrutiva do Sono/epidemiologia , Índice de Massa Corporal , Criança , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Tonsila Palatina/patologia , Polissonografia/métodos , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/etiologia , Fatores Socioeconômicos
17.
Chest ; 138(3): 519-27, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20173057

RESUMO

OBJECTIVE: Our study aimed to determine the prevalence of habitual snoring (HS) in primary school children and to evaluate the diurnal symptoms and conditions that may be associated with it. METHODS: A validated questionnaire completed by parents was used to assess the sleep and daytime behaviors of Chinese children aged 5 to 14 years. Thirteen primary schools in two representative districts were randomly selected. RESULTS: A total of 6,349 out of 9,172 questionnaires (response rate 69.2%) with complete answers were returned. The prevalence rate of HS was 7.2%. Male sex (odds ratio [OR] [95% CI]: 2.5 [1.7-3.6]), BMI z score (OR [95% CI]: 1.4 [1.1-1.6]), maternal HS (OR [95% CI]: 3.4 [2.0-5.7]), paternal HS (OR [95% CI]: 3.8 [2.7-5.5]), allergic rhinitis (OR [95% CI]: 2.9 [2.0-4.2]), asthma (OR [95% CI]: 2.4 [1.2-5.2]), nasosinusitis (OR [95% CI]: 4.0 [1.5-10.6]), and tonsillitis (OR [95% CI]: 3.1 [1.9-5.1]) in the past 12 months were identified to be independent risk factors associated with HS. HS was also associated with daytime, nocturnal, parasomniac, and sleep-related breathing symptoms. HS was demonstrated to be an independent risk factor for parent-reported poor temper (OR [95% CI]: 1.9 [1.4-2.5]), hyperactivity (OR [95%CI]: 1.7 [1.2-2.5]), and poor school performance (OR [95% CI]: 1.7 [1.2-2.5]). CONCLUSIONS: HS was a significant and prevalent problem in primary school children. Male sex, obesity, parental HS, atopic symptoms, and history of upper respiratory infections were significant risk factors. HS was also associated with sleep-disordered breathing symptoms and adverse neurobehavioral outcomes.


Assuntos
Ronco/complicações , Ronco/epidemiologia , Adolescente , Fatores Etários , Criança , Comportamento Infantil , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Hipercinese , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , Fatores Sexuais , Ronco/psicologia , Temperamento
18.
Pediatr Pulmonol ; 44(11): 1085-92, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19746439

RESUMO

OBJECTIVE: This study was designed to assess the hypothesis that leukotriene receptor antagonists (LTRAs) would provide additional symptom relief in asthmatic children with persistent AR already taking regular antihistamine. The effects of 16-week treatment of LTRA in addition to fexofenadine (FEX) on persistent AR in asthmatic children were examined. STUDY DESIGN: Consecutive children with stable asthma and persistent AR were invited in this randomized, double-blind, placebo-controlled study. After a 2-week run-in period in which subjects were given FEX alone, they were randomly assigned to take LTRA or placebo in addition to FEX for 16 weeks, followed by 8 weeks of follow-up phase with FEX taken alone. Symptom scoring, rhinoscopy, acoustic rhinometry, spirometry, nasal secretion extraction and blood taking for IL-4 and IL-13 analysis were performed after a 2-week run-in and at the end of treatment. RESULTS: Forty-four subjects with a median (IQR) age of 12.2 (10.1-14.1) years were recruited. At week 4 of treatment, the between-group differences in the mean changes of daytime sneezing score (mean difference (95% CI) = -0.35 (-0.59, -0.12), P = 0.004), nighttime sneezing score (mean difference (95% CI) = -0.37 (-0.62, -0.11), P = 0.007) and daytime composite score (mean difference (95% CI) = -1.08 (-1.92, -0.25), P = 0.013) were significant. Acoustic rhinometry also demonstrated a nearly significant difference in nasal volume change between groups at 16 weeks of treatment (mean difference (95% CI) = 0.572 (0.090-1.054), P = 0.021). IL-4 and IL-13 were not detected in the majority of nasal secretion or serum samples. CONCLUSIONS: Additional LTRA provided a more rapid relief on sneezing at the 4-week time point. This combination therapy also maintained a greater nasal volume and this might translate to lesser nasal congestion.


Assuntos
Acetatos/uso terapêutico , Antagonistas dos Receptores Histamínicos H1 não Sedativos/uso terapêutico , Antagonistas de Leucotrienos/uso terapêutico , Quinolinas/uso terapêutico , Rinite Alérgica Perene/tratamento farmacológico , Terfenadina/análogos & derivados , Adolescente , Asma/complicações , Criança , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Rinite Alérgica Perene/complicações , Rinometria Acústica , Terfenadina/uso terapêutico
19.
J Pediatr ; 155(3): 362-8.e1, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19540515

RESUMO

OBJECTIVES: To compare ambulatory blood pressure (ABP) in nonoverweight, prepubertal children with and without primary snoring (PS), and to investigate whether PS is a part of the dose-response relationship between sleep-disordered breathing (SDB) and BP in children. STUDY DESIGN: This was a cross-sectional community-based study involving 190 children age 6 to 13 years. Each participant underwent an overnight sleep study and ABP monitoring after completing a validated sleep symptoms questionnaire. Individual systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial BP were calculated for wake and sleep periods. Subjects were hypertensive if mean SBP or DBP was > 95th percentile (relative to sex and height) of reference. RESULTS: A total of 56 nonsnoring controls, 46 children with PS, 62 children with an apnea-hypopnea index (AHI) of 1 to 3, and 26 children with an AHI > 3 were identified. The daytime and nighttime BP increased across the severity spectrum of SDB. The dose-response trends for the proportion of subjects with nighttime systolic and diastolic hypertension also were significant. Nighttime DBP was significantly higher in the children with PS compared with controls after adjusting for age, sex, and body mass index. CONCLUSIONS: PS was demonstrated to be an aspect of the dose-response relationship between SDB and BP in children and should not be considered completely benign.


Assuntos
Hipertensão/epidemiologia , Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/fisiopatologia , Ronco/epidemiologia , Ronco/fisiopatologia , Adolescente , Fatores Etários , Pressão Sanguínea , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Polissonografia , Índice de Gravidade de Doença , Fatores Sexuais , Síndromes da Apneia do Sono/diagnóstico , Ronco/diagnóstico , Inquéritos e Questionários
20.
Chest ; 136(2): 554-560, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19364814

RESUMO

BACKGROUND: Interrupter respiratory resistance (Rint) is useful in evaluating lung function in children who cannot perform the traditional lung function tests. However, available reference Rint values are confined to whites. Our aims were as follows: (1) to establish reference values in local preschool Chinese children, (2) to examine their relationship with demographic and anthropometric factors, and (3) to determine the 10-min and 6-week repeatability of Rint. METHODS: Rint was measured in preschool children from randomly chosen local kindergartens, and the repeatability of Rint measurement was assessed in a subgroup of subjects 10 min and 6 weeks after the initial measurement. RESULTS: Rint measurement was performed in 509 children between 4 and 6 years of age. Age, height, and weight significantly inversely correlated with Rint values. However, on multiple linear regression, height was the only variable that independently correlated with Rint. Repeat measurements obtained 10 min and 6 weeks after the initial reading in 45 children showed good agreement with little variability, and the interclass correlation coefficients for 10-min and 6-week measurements were 0.877 and 0.923, respectively. CONCLUSION: Rint reference centile curves for Chinese preschool children have been determined. Rint in preschool Chinese children has good short- and long-term repeatability.


Assuntos
Resistência das Vias Respiratórias/fisiologia , Programas de Rastreamento/métodos , Testes de Função Respiratória/métodos , Fatores Etários , Antropometria , Criança , Bem-Estar da Criança , Pré-Escolar , China , Estudos de Coortes , Feminino , Humanos , Modelos Lineares , Masculino , Probabilidade , Valores de Referência , Sistema Respiratório , Fatores Sexuais , Estatísticas não Paramétricas
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