Prevalence and evolution of snoring and the associated factors in two-year-old children

ObjectivesTo evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors.Study designThe study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors.ResultsThe combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5–3.1), which is markedly lower than reported previously.Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2–12.5) or asthma (FB OR 4.3, 1.4–13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2–9.0) and father's (CS OR 3.4, 1.4–8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (OR_a) 2.8, 1.1–6.8), the mother's lower level of education (CS OR_a 2.9, 1.2–7.5, FB OR_a 2.1, 1.0–4.5), and the mother's lower monthly income (FB OR_a 2.9, 1.3–6.3) associated with the child's habitual snoring.ConclusionsThe prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.     

Association between habitual snoring,middle ear disease,and speech problems in young children with non-syndromic cleft palate anomalies

The purpose of this study was to investigate the association between habitual snoring (HS), middle ear disease (MED), and speech problems in children with cleft palate. This cross-sectional study included children aged 2.0–7.9 years with non-syndromic cleft palate anomalies. Parents completed the Pediatric Sleep Questionnaire and a questionnaire about MED. Audiograms and speech assessment were also conducted. Ninety-five children were enrolled; 15.2% of families reported HS, 97.6% MED, and 17.1% speech problems. HS (37.5% vs 10.3%, P = 0.007) and early episodes of MED (92.3% vs 58.2%, P = 0.021) were more likely to be reported for children with isolated cleft palate when compared to those with cleft lip and palate. Children with cleft lip and palate had a higher frequency of MED with effusion compared to those with Robin sequence (86.4% vs 57.1%, P = 0.049). The odds ratio for HS in children with ≥1 episode of MED in the last year was 7.37 (95% confidence interval 1.55–35.15, P = 0.012). There was a trend for children with speech problems reported by parents to have HS (30.8% vs 11.5%, P= 0.076). Anatomical factors play a role in the frequency of upper airway symptoms in children with cleft palate. A recent history of at least one episode of MED was associated with an increased frequency of HS.     

阻塞性睡眠呼吸暂停低通气综合征与血脂水平相关性的meta分析

目的 系统评价阻塞性呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)与血脂水平的相关性,探讨OSAHS患者血脂水平变化的临床意义。方法 计算机检索PubMed、Cochrane Library、中国学术期刊全文数据库(CNKI)、维普网、万方数据库,对纳入文献和相关综述的参考文献进行手工检索,查找公开发表的有关OSAHS与血脂水平相互关系的病例对照研究,检索时限均为建库至2018年12月。由2位研究者独立进行筛选、提取资料和评价偏倚风险后,采用RevMan5.3软件进行meta分析。结果 通过筛选,总共纳入9个研究,包括1473个患者。Meta分析结果显示,OSAHS患者的甘油三酯[MD=0.60, 95%CI(0.54,0.67),P<0.01]及低密度脂蛋白[MD=0.25, 95%CI(0.02,0.49), P<0.01]水平高于对照组,高密度脂蛋白[MD=-0.17, 95%CI(-0.25,-0.08), P<0.01]水平低于对照组。结论 Meta分析结果表明,OSAHS患者常合并有血脂异常,然而,因为受纳入研究数量及研究质量的限制,上述结论及相关机制仍需更高质量及更大样本的试验研究进一步验证。     

小儿鼾症手术前后血浆生物标志物的变化及临床意义

探讨小儿鼾症患者行扁桃体和（或）腺样体手术对与心血管疾病密切相关的血浆生物标志物的影响。选取单纯非肥胖型小儿鼾症患者20例,进行术前和术后6个月血浆超敏 C 反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）、白介素6（IL-6）、脂联素和胎球蛋白 A 的水平的测定,结果显示术后6个月的血浆 hs-CRP、TNF-α、IL-6、脂联素的水平均明显低于相应的术前水平（P <0.001）,胎球蛋白 A 的水平均明显高于相应的术前水平（P <0.001）。小儿鼾症患者进行扁桃体和（或）腺样体切除术有助于降低其并发心血管疾病的风险。     

Increased risk for new‐onset hypertension in midlife male snorers: The 14‐year follow‐up study

While the association between sleep‐related breathing disorders such as snoring and hypertension has been well established, it still remains unclear whether the association differs by age and gender. Therefore, in this 14‐year follow‐up study, we examined the independent association between self‐reported snoring and the incidence of hypertension by gender and age groups in a large cohort of Korean adults. A total of 4,954 adults, aged 40–69 years, free of hypertension at baseline were enrolled. Participants were divided into three groups based on a self‐reported snoring frequency: never; occasional (snoring <4 nights per week); and habitual snorer (snoring ≥4 nights). At baseline and biennial follow‐up visits, blood pressure was measured by trained examiners. Incident hypertension was defined as the first occurrence at any follow‐up examination where the participants had blood pressure ≥140/90 mmHg or were being treated with antihypertensive medication. After adjusting for known cardiovascular risk factors, only in men aged ≤45 years was habitual snoring significantly associated with a 1.5 times higher risk for incident hypertension than never snoring. In this age group, habitual snoring was significantly associated with increased risk for the development of hypertension, regardless of the presence of excessive daytime sleepiness. In women, snoring was not significantly associated with hypertension incidence in any age group. The present study suggests that young male snorers may be at high risk for the future development of hypertension, which has important clinical implications for early detection and treatment of snoring to reduce the burden of cardiovascular disease.     

Retropharyngeal lipoma presenting with snoring in a child

Retropharyngeal lipoma in a child is an extremely rare pathological entity. The unusual case of a child with a retropharyngeal lipoma presenting with snoring is reported. Retropharyngeal lipoma should be considered in the differential diagnosis of snoring in children.     

Asthma and subjective sleep disordered breathing in a large cohort of urban adolescents

Objective: Sleep disordered breathing (SDB) has not been well studied in urban adolescents with asthma in community settings. Nor has the association of SDB symptoms and asthma severity been studied. We characterized self-reported symptoms suggesting SDB and investigated the association of SDB symptoms, probable asthma, and asthma severity. Methods: 9,565 adolescents from 21 inner-city high schools were screened for an asthma intervention study. Students reported on symptoms suggesting SDB using questions from the 2007 NHANES, if they were ever diagnosed with asthma, and on asthma symptoms. Using generalized linear mixed models with logit link with school as a random intercept and adjusting for age, gender, and race/ethnicity, we examined associations of SDB symptoms, and demographic characteristics, probable asthma, and asthma severity. Results: 12% reported SDB symptoms. Older and bi-racial participants (compared to Caucasian) had higher odds of symptoms suggesting SDB (p <.001). Compared to those without probable asthma, adolescents with probable asthma had 2.63 greater odds of reporting SDB symptoms (p <.001). Among those with probable asthma, the odds of reporting SDB symptoms increased with asthma severity. When exploring daytime severity and severity due to night wakening separately, results were similar. All results remained significant when controlling for age, gender, and ethnicity. Conclusions: In a large urban community cohort of predominately ethnic minority adolescents, self-reported SDB symptoms were associated with probable asthma and increased asthma severity. This study highlights the importance of SDB as a modifiable co-morbidity of asthma.     

Association of sleep duration and incidence of diabetes modified by tea consumption: a report from the Shanghai men's health study

ObjectivesTo evaluate the association between sleep duration and the incidence of diabetes stratified by sleep-related factors among Chinese men.MethodsThis study included 34,825 men who provided information on sleep-related questions in the Shanghai Men's Health Study, a population-based cohort study conducted in Shanghai, China from 2002 to 2011. Participants were excluded who had a history of diabetes or who were diagnosed with diabetes within 2 years of recruitment. Cox regression was employed to evaluate the influence of sleep duration and its interaction with sleep-related factors on diabetes risk.ResultsA total of 1521 incident cases were documented during a median of 5.6 follow-up years. Adjusted hazard ratios and 95% confidence intervals were 1.0 (0.9–1.1) and 1.2 (1.0–1.3) for men who slept <7 and ≥8 h per day, respectively, compared with those who slept 7 h per day (p_trend = 0.01). Stratified analyses revealed that the association between sleep duration and risk of diabetes was only statistically significant among current smokers and regular drinkers, never tea drinkers, men with a high body mass index, hypertension or comorbidity, and men who did not work nightshift or who snored. A statistically significant interaction between tea drinking and sleep duration was observed (p_interaction = 0.01). The above association patterns remained when daytime nappers were excluded from the analyses.ConclusionsThe data suggested that longer sleep duration, particularly among individuals already exhibiting factors linked to poor quality of sleep, was associated with diabetes. The association between sleep duration and diabetes may be modified by tea drinking, especially in older men or men with more sleep-related factors.