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OSA SYNDROME AND ALLERGIC RESPIRATORY DISEASES Upper Airway Diseases A. Kaditis, MD

OSA SYNDROME AND ALLERGIC RESPIRATORY DISEASES Upper Airway Diseases A. Kaditis, MD. Pediatric Pulmonology Unit, Sleep Disorders Laboratory First Department of Pediatrics University of Athens School of Medicine and Aghia Sophia Children’s Hospital Athens, Greece.

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OSA SYNDROME AND ALLERGIC RESPIRATORY DISEASES Upper Airway Diseases A. Kaditis, MD

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  1. OSA SYNDROME AND ALLERGIC RESPIRATORY DISEASESUpper Airway DiseasesA. Kaditis, MD Pediatric Pulmonology Unit, Sleep Disorders Laboratory First Department of Pediatrics University of Athens School of Medicine and Aghia Sophia Children’s Hospital Athens, Greece

  2. Obstructive Sleep-Disordered Breathing (SDB) Spectrum of abnormal respiratory patterns during sleep characterized by snoring and increased respiratory effort • Primary snoring • Upper airway resistance syndrome • Obstructive hypoventilation • Obstructive sleep apnea (OSA)

  3. Genes, environment Genes, environment Multiple Disorders affecting components of the Upper Airway (e.g. tonsils, facial structures, dilator muscles) Upper Airway Dysfunction over time may lead to overt morbidity (e.g. hypertension, enuresis, EDS) Upper Airway Resistance OSA: Syndrome of Upper Airway Dysfunction

  4. Apnea Hypopnea

  5. Upper Airway Dysfunction and Adenotonsillar Hypertrophy

  6. Villa et al.Randomized controlled study of an oral jaw-positioning device for treatment of OSA in children with malocclusion. AJRCCM 2002;165:123-7

  7. Amin et al. Activity-adjusted 24-hour ambulatory BP and cardiac remodeling in children with SDB. Hypertension 2008;51:84-91

  8. Hyperactivity Inattention Excessive daytime sleepiness Learning problems Obstructive SDB in Childhood and CNS Morbidity Evidence from population-based studies

  9. Kaditis et al. Enuresis and Snoring in Healthy Children.Urology 2006; 68:406-9

  10. Redline et al.Risk Factors for SDB in Children.AJRCCM 199;159:1527

  11. Goodwin et al. Incidence and Remission of SDB and Related Symptoms in 6- to 17-y.o children. J Pediatr 2010;157:57-61

  12. Goodwin et al. Incidence and Remission of SDB and Related Symptoms in 6- to 17-y.o children. J Pediatr 2010;157:57-61

  13. Berlucchi et al.The Role of Mometasone Nasal Spray in the Treatment of Adenoidal Hypertrophy. Pediatrics 2007;119:e1392-1397 Mometasone 100 mcg/d(40 days) vs.Placebo(40 days)

  14. Villa et al.Randomized controlled study of an oral jaw-positioning device for treatment of OSA in children with malocclusion. AJRCCM 2002;165:123-7

  15. Villa et al.Randomized controlled study of an oral jaw-positioning device for treatment of OSA in children with malocclusion. AJRCCM 2002;165:123-7 Before After

  16. Bhattarjee et al. AT outcomes in Treatment of OSA in Children.AJRCCM 2010; 182:676-683

  17. Conclusions Intermittent upper airway obstruction during sleep in childhood: • Is associated with disorders affecting upper airway resistance and pharyngeal neuromotor tone • Is related to morbidity from the CNS and the cardiovascular system • Severe upper airway obstruction during sleep and mild obstruction with morbidity or risk factors for persistenceshould be treated • All disorders leading to upper airway obstruction should be addressed in a stepwise fashion

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