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Biomedical subjects

Eleni Kostadima

Publications and source records attributed to Eleni Kostadima.

9 recordsLinked to original sources
PubMed2006

Association between primary nocturnal enuresis and habitual snoring in children.

OBJECTIVES: Nocturnal enuresis has been associated with obstructive sleep-disordered breathing mostly in hospital-referred adults and children. To investigate whether primary nocturnal enuresis is significantly associated with habitual snoring in the general pediatric population irrespective of subjects' age and sex, we studied children attending six randomly selected schools in a city in central Greece. METHODS: A questionnaire regarding the symptoms of sleep-disordered breathing and the presence of nocturnal enuresis (bedwetting for at least one night per week) was answered by the children's parents. RESULTS: A total of 1821 children (age 5 to 14 years; 896 girls) were included in the study. Of these, 135 (7.4%) were snoring more frequently than three nights per week (habitual snorers). The habitual snorers had a history of primary nocturnal enuresis more often than did nonhabitual snorers (7.4% versus 2%; odds ratio 4.00, 95% confidence interval 1.93 to 8.32). The association of primary nocturnal enuresis with habitual snoring remained significant after adjustment for age and sex (odds ratio 3.54, 95% confidence interval 1.68 to 7.44). CONCLUSIONS: In a community sample of children, those with habitual snoring more often had primary nocturnal enuresis than did those without snoring.

Adolescent↗
PubMed2006

Overnight change in brain natriuretic peptide levels in children with sleep-disordered breathing.

STUDY OBJECTIVES: Obstructive sleep-disordered breathing is accompanied by episodic increases in left ventricle afterload due to large negative swings in intrathoracic pressure and repetitive surges in arterial pressure. Brain natriuretic peptide (BNP) is released by ventricular myocytes in response to pressure and volume overload. It was hypothesized that in children with snoring, overnight change in BNP levels is correlated with severity of disturbance in respiration. DESIGN: Evening and morning plasma levels of BNP were measured in children with snoring referred for polysomnography. SETTING: A sleep disorders laboratory in a university hospital. PARTICIPANTS: Twenty-two children with apnea-hypopnea index (AHI) > or = 5/h (mean +/- SD age, 6.4 +/- 2.5 years), 60 children with AHI < 5/h (mean age, 7 +/- 2.9 years), and 27 control subjects without snoring (mean age, 7.8 +/- 3.7 years) were recruited. MEASUREMENTS AND RESULTS: Overnight change in BNP (log-transformed ratio of morning-to-evening levels) was larger in children with AHI > or = 5/h, compared to those with AHI < 5/h or to control subjects (0.1 +/- 0.19 vs 0.01 +/- 0.14 vs - 0.06 +/- 0.18; p < 0.05). Children with AHI > or = 5/h had an odds ratio of 4.33 (95% confidence interval, 1.34 to 14) for change in peptide levels > 0.15 relatively to subjects with AHI < 5/h. AHI and oxygen saturation of hemoglobin nadir were significant predictors of overnight change in peptide levels. CONCLUSIONS: In children with snoring, overnight increase in BNP levels is correlated with severity of disturbance in respiration during sleep, which may indicate presence of nocturnal cardiac strain.

Adolescent↗
PubMed2005

Obstructive sleep-disordered breathing and plasma levels of vascular endothelial growth factor in children.

Vascular endothelial growth factor (VEGF) may be one of the pathophysiologic links in the association between obstructive sleep apnea-hypopnea and cardiovascular disease. Morning serum VEGF levels are increased in children with obstructive sleep apnea. However, release of VEGF by platelets and leukocytes during blood clotting may affect its concentration in serum. In the present study, VEGF levels were measured in children with and without habitual snoring using plasma specimens. Evening and morning plasma VEGF concentrations were determined in: (i) 20 children with habitual snoring and apnea-hypopnea index (AHI)5 episodes/h (median age 5; range 1.9-13 years); (ii) 55 children with snoring and AHI<5 episodes/h (median age 6; 2-13 years); and (iii) 25 controls without snoring (median age 6.5; 3-13 years). No differences were identified between the three study groups regarding evening [median 2.5 (range 2.5-174.5) versus 22.5 (2.5-159.4) versus 26.8 (2.5-108) pg/mL; P>0.05] and morning VEGF levels [median 7.7 (range 2.5-120.5) versus 25.1 (2.5-198.4) versus 48.4 (2.5-147.7) pg/mL; P>0.05]. AHI and % sleep time with oxygen saturation of hemoglobin less than 90% were not significant predictors of log-transformed morning VEGF concentrations (P>0.05). In summary, both evening and morning plasma VEGF levels were similar in children with obstructive sleep-disordered breathing of variable severity and in controls without snoring. VEGF may not play an important pathophysiologic role in all cases of obstructive sleep-disordered breathing in childhood.

Adolescent↗
PubMed2005

Comparison of blood pressure measurements in children with and without habitual snoring.

Higher or similar systolic and/or diastolic blood pressure has been recorded in children with sleep apnea compared to subjects with primary snoring or in those with primary snoring compared to controls. To investigate the association between blood pressure and habitual snoring, we studied children in four randomly selected schools in central Greece. A symptom questionnaire was answered by parents, and children's weight, height, and blood pressure were measured. Seven hundred and sixty children (4-14 years old; 352 female) were recruited. Fifty of 760 (6.6%) participants were snoring more than 3 nights/week (habitual snorers). Mean (+/- SD) systolic blood pressure was 106.9 (+/-10.6) mmHg in habitual snorers vs. 107 (+/- 12) in nonhabitual snorers (P > 0.05). Mean diastolic blood pressure was 61.9 (+/- 7.6) in the former vs. 61.8 (+/- 6.8) in the latter (P > 0.05). While age, gender, and body mass index were significant predictors of systolic blood pressure in a general linear model, snoring was not. Similarly, that gender and body mass index but not snoring were significant predictors of diastolic blood pressure. In a community sample of children, habitual snorers do not have higher morning systolic or diastolic blood pressure than nonhabitual snorers.

Adolescent↗
PubMed2005

Obstructive sleep-disordered breathing and fasting insulin levels in nonobese children.

A positive correlation of severity of sleep-disordered breathing with morning fasting insulin levels, which is independent of obesity, was reported in adults and obese children. We hypothesized that both severity of sleep-disordered breathing and relative body mass index predict fasting insulin and homeostasis model assessment (HOMA) index values in nonobese children with habitual snoring. One hundred and ten subjects with habitual snoring (median age, 6 years; range, 2-13 years) underwent polysomnography and measurement of morning fasting insulin and glucose levels. The HOMA index was calculated. Thirty children had an apnea-hypopnea index (AHI) >/= 5 episodes/hr (median, 7.8 episodes/hr; range, 5-42.3 episodes/hr), and 80 subjects had an AHI < 5 episodes/hr (median, 1.9 episodes/hr; range, 0.2-4.9 episodes/hr). Insulin and HOMA index values were similar in children with AHI >/= 5 episodes/hr (median insulin, 4.9 mU/l; range, 1.66-19.9 mU/l; and median HOMA, 1; range, 0.36-4.95) and in subjects with AHI < 5 episodes/hr (median insulin, 5.8 mU/l; range, 0.74-41.1 mU/l; and median HOMA, 1.3; range, 0.13-9.72) (P > 0.05). No significant correlations were identified between insulin or HOMA index values and any polysomnography indices (P > 0.05). When multiple linear regression was carried out, relative body mass index was a significant predictor of log-transformed insulin levels or HOMA index values, but AHI and percentage of sleep time with saturation <95% were not. In conclusion, contrary to findings in adults and in obese children, severity of sleep-disordered breathing is not a significant predictor of fasting insulin or HOMA index values in nonobese children with habitual snoring.

Adolescent↗
PubMed2005

Resolution of nocturnal enuresis in snoring children after treatment with nasal budesonide.

Nocturnal enuresis has been associated with obstructive sleep apnea-hypopnea and may resolve after adenotonsillectomy. Nasal corticosteroids have improved symptoms and polysomnography findings in children with snoring. Two children with primary nocturnal enuresis, chronic nasal obstruction, and loud snoring underwent polysomnography. The apnea-hypopnea index was 4.9 and 7.3 episodes/hr, and the oxygen desaturation of hemoglobin index was 4.6 and 5.2 episodes/hr. After administration of budesonide, the frequency of snoring decreased, the polysomnography findings improved, and the enuresis resolved completely. Six months after treatment, both children were still dry at night. Administration of nasal corticosteroids is associated with resolution of enuresis in children with mild obstructive sleep-disordered breathing.

Administration, Intranasal↗
PubMed2004

Morning levels of C-reactive protein in children with obstructive sleep-disordered breathing.

Obstructive sleep-disordered breathing is associated with cardiovascular disease in adults, and elevated C-reactive protein (CRP) has been proposed as a link between the two disorders. We hypothesized that children with sleep-disordered breathing have higher CRP values than do control subjects. CRP was measured in 39 children (mean age +/- SD: 6.9 +/- 3.2 years) without snoring (controls) and in 102 children (6.2 +/- 2.2 years) with habitual snoring who underwent polysomnography. No significant differences were found in mean CRP values between control subjects (0.12 +/- 0.16 mg/dl; n = 39) and snorers with an apnea-hypopnea index of less than 1 episode/hour (0.15 +/- 0.26; n = 18), snorers with an index of 1 or more and less than 5 (0.15 +/- 0.26; n = 54), and snorers with an index of 5 or more (0.22 +/- 0.43; n = 30; p > 0.05). There was no correlation between CRP or log-transformed CRP values and apnea-hypopnea index, respiratory movement/arousal index, Sa(O(2)) nadir, oxygen desaturation (>/= 4%) of hemoglobin index, or percentage of sleep time with saturation less than 95% (p > 0.05). Thus, findings of higher CRP values in adults with sleep-disordered breathing and correlations of these values with polysomnography indices were not confirmed in children.

Adolescent↗
PubMed2004

Nasal corticosteroids for children with snoring.

Nasal corticosteroids improve polysomnography indices but not symptoms in children with mild to moderate sleep-disordered breathing. We hypothesized that administration of nasal corticosteroids for 4 weeks to snoring children with only mild elevation in their apnea-hypopnea index would improve both polysomnography findings and symptoms of sleep-disordered breathing. Budesonide 50 mcg per nostril twice daily was administered for 4 weeks to children (2-14 years old) with habitual snoring and an apnea-hypopnea index of 1-10 episodes/hr. Subjects were evaluated before treatment and at 2 weeks and 9 months after its completion. Primary outcome variables were changes in apnea-hypopnea index and symptom score. Twenty-seven children were studied. At 2 weeks, the mean apnea-hypopnea index decreased from 5.2 (+/-2.2) episodes/hr to 3.2 (+/-1.5) episodes/hr, and median oxygen desaturation of hemoglobin index fell from 3.1 (0.4-8.2) to 1.9 (0.2-5.4) (P < 0.0001). Mean symptom score was 1.33 (+/-2.11) at baseline, and decreased to -0.008 (+/-2.24) at 2 weeks after treatment and to -1.08 (+/-1.75) at 9 months after treatment (P < 0.05). Four weeks of nasal budesonide improved both polysomnography findings and symptoms in children with mild sleep-disordered breathing. The clinical effect is maintained for several months after treatment.

Administration, Intranasal↗