The impact of respiratory function on children's craniofacial growth has received increasing attention from orthodontists and parents. There is a higher pediatric sleep-disordered breathing risk prevalence in the orthodontic population compared with a general population sample, and orthodontic practitioners need to pay close attention to the respiratory function of their pediatric patients. For children with upper airway obstruction and related dentofacial and functional abnormalities, clinicians should comprehensively consider the site and severity of upper airway obstruction, the clinical feature of malocclusion and other factors to develop an individual, multidisciplinary treatment plan, providing favorable conditions for the development of the children's craniofacial morphology and the whole body.
Airway Obstruction/therapy* ; Child ; Humans ; Malocclusion/therapy* ; Prevalence ; Sleep Apnea Syndromes/therapy*

Humans ; Polysomnography ; Sleep Apnea Syndromes/therapy*

Sleep-disordered breathing (SDB) induces dysfunction of the orofacial muscles, leading to morphologic alteration of the face and dental malalignment. Early diagnosis and treatment of SDB is required in pediatric patients to ensure normal facial growth. Myofunctional therapy (MFT) is a modality for the treatment of SDB and prefabricated appliances can be used. Herein 2 cases of malocclusion with SDB, in which MFT with a prefabricated appliance was used for orthodontic treatment, have been described. SDB was diagnosed based on clinical symptoms taken by interview and home respiratory polygraphy. In both cases, SDB was improved using prefabricated appliance for MFT. However, resolution of crowding depended on the degree of crowding.
Child ; Crowding ; Early Diagnosis ; Humans ; Malocclusion ; Muscles ; Myofunctional Therapy ; Sleep Apnea Syndromes

Atrial fibrillation (AF) and heart failure (HF) are growing cardiovascular disease epidemics worldwide. There has been an exponential increase in the prevalence of AF and HF correlating with an increased burden of cardiac risk factors and improved survival rates in patients with structural heart disease. AF is associated with adverse prognostic outcomes in HF and is most evident in mild-to-moderate left ventricular (LV) dysfunction where the loss of “atrial kick” translates into poorer quality of life and increased mortality. In the absence of underlying structural heart disease, arrhythmia can independently contribute to the development of cardiomyopathy. Together, these 2 conditions carry a high risk of thromboembolism due to stasis, inflammation and cellular dysfunction. Stroke prevention with oral anticoagulation (OAC) remains a mainstay of treatment. Pharmacologic rate and rhythm control remain limited by variable efficacy, intolerance and adverse reactions. Catheter ablation for AF has resulted in a paradigm shift with evidence indicating superiority over medical therapy. While its therapeutic success is high for paroxysmal AF, it remains suboptimal in persistent AF. A better mechanistic understanding of AF as well as innovations in ablation technology may improve patient outcomes in the future. Refractory cases may benefit from atrioventricular junction ablation and biventricular pacing. The value of risk factor modification, especially with regard to obesity, sleep apnea, hypertension and diabetes, cannot be emphasized enough. Close interdisciplinary collaboration between HF specialists and electrophysiologists is an essential component of good long-term outcomes in this challenging population.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Resynchronization Therapy ; Cardiomyopathies ; Cardiovascular Diseases ; Catheter Ablation ; Cooperative Behavior ; Heart Diseases ; Heart Failure* ; Heart* ; Humans ; Hypertension ; Inflammation ; Mortality ; Obesity ; Prevalence ; Quality of Life ; Risk Factors ; Sleep Apnea Syndromes ; Specialization ; Stroke ; Survival Rate ; Thromboembolism

Attention-deficit hyperactivity disorder (ADHD) is notorious for its debilitating consequences and early age of onset. The need for early diagnosis and intervention has frequently been underscored. Previous studies have attempted to clarify the bidirectional relationship between ADHD and sleep problems, proposing a potential role for sleep problems as early predictors of ADHD. Sleep deprivation, sleep-disordered breathing, and circadian rhythm disturbances have been extensively studied, yielding evidence with regard to their induction of ADHD-like symptoms. Genetic-phenotypic differences across individuals regarding the aforementioned sleep problems have been elucidated along with the possible use of these characteristics for early prediction of ADHD. The long-term consequences of sleep problems in individuals with ADHD include obesity, poor academic performance, and disrupted parent-child interactions. Early intervention has been proposed as an approach to preventing these debilitating outcomes of ADHD, with novel treatment approaches ranging from melatonin and light therapy to myofunctional therapy and adjustments of the time point at which school starts.
Age of Onset ; Circadian Rhythm ; Early Diagnosis ; Early Intervention (Education) ; Humans ; Melatonin ; Myofunctional Therapy ; Obesity ; Phototherapy ; Sleep Apnea Syndromes ; Sleep Deprivation

After more than 30 years of development, noninvasive positive pressure ventilation (NPPV) has become one of the main treatments of sleep-disordered breathing (SDB) in the world. It is the wide application of this technology that makes breakthrough in SDB treatment, and has given rise to a new interdisciplinary area sleep medicine. In China, sleep medicine started in late of 1980's, in recent years, with the development of economy and the improvement of recognization, the application of NPPV in Chinese market has become one of the fastest growing in the world. NPPV technology also extends gradually to the treatments of patients with respiratory failure due to different causes, such as severe acute respiratory syndrome and COPD.
China ; Humans ; Positive-Pressure Respiration ; Respiratory Insufficiency ; Sleep Apnea Syndromes ; therapy ; Sleep Medicine Specialty ; trends

The sleep breathing disorders (SDB) include obstructive sleep apnea (OSA), central sleep apnea disorders, sleep related hypoventilation disorders, and sleep related hypoxemia disorder in international classification of sleep diseases 3rd edition (ICSD-3). Latest diagnosis criteria are introduced. Treatments, which target to Individual contributors, should be applied. Thus identification of the phenotype in patients with OSA is important. The methods of evaluation patients' arousal thresholds, loop gain as well as neuromyopathy in clinical setting are reported. Several new treatment strategies are developed and applied for OSA. Long term follow up and more data are needed for evaluation the outcomes of hypoglossal nerve stimulation, bariatric surgery as well as medicine as treatments for OSA.
Humans ; Sleep Apnea Syndromes ; diagnosis ; therapy ; Sleep Apnea, Central ; Sleep Apnea, Obstructive

OBJECTIVETo observe the clinical curative effect of anti-reflux treatment for obstructive sleep apnea hypopnea syndrome (OSAHS) in children.

METHODSTwenty children with sleep-disordered breathing were included in this study. There were 15 males and 5 females, aged 3-9 years old, median 6 years old. The electronic laryngoscope, polysomnography (PSG) monitoring, Reflux symptom index (RSI) questionnaire and Reflux finding score (RFS) were used to establish the initial diagnosis of OSAHS with LPRD, preclude adenoid hypertrophy and tonsil hypertrophy and nasal disorders. Oral Domperidone and Omeprazole were given for treatment. For children under 3-year-old, the dosage of Domperidone was 0.6 ml.kg⁻¹.day⁻¹.For children over 3-year-old, Domperidone combined with Omeprazole were given with the dosage of 0.3 mg.kg⁻¹.day⁻¹.

RESULTSAfter 4 weeks of treatment, 19 patients symptoms of OSAHS include disturbed sleep, dyspnoea and apneic attack improved. After 8 weeks of treatment, 20 cases with OSAHS symptoms improved than before treatment. Under the electronic laryngoscope, the decrease in pharyngeal lymphoid follicles, the epiglottis, aryepiglottic fold and scoop intergenic region erythema shallow, edema lessened. After treatment of 4 weeks and 8 weeks, there was statistically significant (P < 0.05). Before and after treatment, the difference of RFS was statistically significant (P < 0.05); PSG monitoring proved significant effect in 3 cases (15.0%), effective in 11 cases (55.0%) and 6 cases were ineffective (30.0%). Twenty patients with obstructive apnea index change was not obvious (P > 0.05), apnea hypopnea index and lowest artery oxygen saturation better, differences were statistically significant (Z of 2.819 and 2.733 respectively, P < 0.05).

CONCLUSIONThe treatment of LPRD can improve the symptoms of OSAHS, these two diseases may coexist in mutual relations.

Child ; Child, Preschool ; Female ; Humans ; Laryngopharyngeal Reflux ; complications ; drug therapy ; Male ; Sleep Apnea Syndromes ; complications ; drug therapy ; Surveys and Questionnaires ; Treatment Outcome

Continuous Positive Airway Pressure ; Facial Bones ; abnormalities ; Humans ; Infant ; Larynx ; pathology ; Oxygen Inhalation Therapy ; Pharynx ; pathology ; Polysomnography ; Respiration ; Risk Factors ; Sleep Apnea Syndromes ; diagnosis ; etiology ; therapy ; Sleep Apnea, Obstructive ; diagnosis ; etiology ; therapy

Obesity, that is, having a body mass index (BMI) >30 kg/m2, has increased dramatically and became the most single most common preventable cause of death in South Korea. In the end, obesity results in metabolic syndrome, which includes abdominal obesity, increased triglycerides, decreased high-density lipoprotein, hypertension, and impaired glucose tolerance. Nonsurgical methods for obesity treatments include dietary therapy, exercise counseling, behavioral therapy, psychiatric therapy, and pharmacotherapy. Surgical methods for obesity treatments, laparoscopic gastric banding and Roux-en-Y gastric bypass, are commonly performed for obese patients, particularly those with a BMI of 40 kg/m2 or at BMI more than 30 kg/m2 with accompanying diseases related to metabolic syndrome such as hypertension, type 2 diabetes, hypercholesterolemia, asthma, angina, other cardiopulmonary diseases, infertility, polycystic ovary, urinary incontinence, severe arthritis, or Pickwickian syndrome. Preoperative evaluation for bariatric surgery should focus on airway management, sleep apnea history, use of a continuous positive airway pressure device, and comorbid systemic diseases. Special consideration and pharmacokinetic knowledge is needed for the choice and dose of the anesthetic agents as well as postoperative pain control, patient monitoring, fluid intake, and surgical complications. Obesity is a disease. Appropriate surgical intervention and peri-operative anesthetic care for bariatric surgery will increase the safety and satisfaction of obese patients and will finally provide a better quality of life for our society.
Airway Management ; Anesthesia ; Anesthetics ; Arthritis ; Asthma ; Bariatric Surgery ; Body Mass Index ; Cause of Death ; Continuous Positive Airway Pressure ; Counseling ; Exercise Therapy ; Female ; Gastric Bypass ; Glucose ; Humans ; Hypercholesterolemia ; Hypertension ; Infertility ; Lipoproteins ; Monitoring, Physiologic ; Obesity ; Obesity Hypoventilation Syndrome ; Obesity, Abdominal ; Ovary ; Pain, Postoperative ; Quality of Life ; Republic of Korea ; Sleep Apnea Syndromes ; Triglycerides ; Urinary Incontinence