(Press-News.org) Surgery beneficial for some children with mild sleep-disordered breathing
NIH-supported study shows better sleep, blood pressure after adenotonsillectomy
Surgical removal of the tonsils and adenoids in children with snoring and mild breathing problems during sleep appears to improve their sleep, quality of life, and blood pressure a year after surgery, a clinical trial supported by the National Institutes of Health has found. The study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of NIH, is believed to be the first large, randomized trial to address the effects of adenotonsillectomy on children with mild sleep-disordered breathing (SDB). Adenotonsillectomy is among the most common surgical procedures in children, and mild SDB is an issue for a large proportion of these patients. The findings were published in the Journal of the American Medical Association.
“Our data suggest that for children with no symptoms other than snoring, it's reasonable to monitor them over time without proceeding to surgery,” said study leader Susan Redline, M.D., M.P.H., of Brigham and Women’s Hospital and Harvard Medical School, both in Boston. “However, for children who are having issues with disturbed sleep, daytime sleepiness, and behavioral problems, our data suggest that surgery may be a very reasonable option.”
SDB refers to breathing disturbances during sleep that can range from loud snoring to sleep apnea. SDB affects 6-17% of typically developing children in the United States. Some research indicates that if left untreated, the condition may increase the risk for behavioral problems, reduced quality of life, and cardiovascular diseases, including heart disease and high blood pressure. Researchers and parents are showing increasing interest in how sleep problems such as sleep apnea might also affect brain development, cognition, and academic performance.
Adenotonsillectomy, or removal of enlarged tonsils and adenoids, is a standard treatment for children with moderate to severe SDB and is aimed at reducing snoring and improving breathing in those with the condition. However, data are unclear whether the surgery is beneficial for children with mild forms of SDB.
The Pediatric Adenotonsillectomy Trial for Snoring (PATS) was a randomized clinical trial that involved 459 children and adolescents with mild SDB who were enrolled at seven academic sleep centers in the United States between 2016 to 2021. The participants were ages 3 to 12, racially diverse, and followed for a year. The study did not include children with moderate to severe SDB.
During the trial, half the participants received an adenotonsillectomy and the other half received supportive care without surgery, which included standardized education on healthy sleep and lifestyle and referral for untreated allergies or asthma. Researchers then evaluated neurodevelopmental, behavioral, health, and sleep-related outcomes in these groups, using measurements of attention and executive function, which includes a set of cognitive skills that help children manage everyday activities. Sleep outcomes were measured by polysomnography, a standard sleep test that measures breathing, heart rate, eye movement, and other factors.
At the end of the study period, cognition and attention improved in both groups, but improvement was not significantly greater in the children who were treated with surgery compared to the group who did not receive surgery. However, the secondary results of the study did show several beneficial changes in the surgery group. These included less daytime sleepiness, reduced SDB, less snoring, fewer behavioral problems, better quality of life, and lower blood pressure. The children treated with surgery were also less likely to show disease progression into full-blown sleep apnea, the researchers said.
Researchers plan to explore the long-term impacts of surgery in this population and note the need to develop improved screening tools that better identify which children are most likely to benefit from adenotonsillectomy.
“It is clear that adenotonsillectomy can help some children with mild sleep-disordered breathing. However, it may not be appropriate for everyone,” said Marishka Brown, Ph.D., director of the National Center on Sleep Disorder’s Research within the NHLBI. “Parents with concern over their children's nighttime breathing should discuss options with their pediatrician to develop a plan of action.”
This work was supported by NHLBI cooperative agreements 1U01HL125307 and 1U01HL125295. Clinical trial: NCT02562040
Study: Redline, S, et al. Adenotonsillectomy for snoring and mild sleep apnea in children: A randomized clinical trial. Journal of the American Medical Association. DOI: 10.1001/jama.2023.22114
###
About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit www.nhlbi.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
END
Neutron stars have fascinated and puzzled scientists since the first detected signature in 1967. Known for their periodic flashes of light and rapid rotation, neutron stars are among the densest objects in the universe, with a mass comparable to that of the Sun but compressed into a sphere only about 20 kilometers in diameter. These stellar objects exhibit a peculiar behavior known as a “glitch”, where the star suddenly speeds up its spin. This phenomenon suggests that neutron stars might be partly superfluid. In a superfluid, rotation is characterized by numerous tiny vortices, each carrying ...
They published their work on October. 23 in Energy Material Advances.
"It is imperative to develop energy-saving, safe and sustainable photocatalytic mercury removal technology," said paper author Wu Jiang, professor with College of Energy and Mechanical Engineering of Shanghai University of Electric Power. "Currently, thermocatalytic technologies account for most of the market, but they are constrained in terms of manufacturing costs and sustainability."
Wu ...
Medicare is the single largest provider of health insurance in the United States, serving 63.8 million senior citizens as of 2022. Three-quarters of these recipients are enrolled in optional Medicare Part D plans, which provide outpatient prescription drug coverage to seniors through private insurance companies. In 2022, Medicare paid more than $160 Billion for prescription drugs, making it the single largest payer of pharmaceuticals in the US.
While Medicare is meant to keep healthcare affordable for seniors, millions of Americans still face steep costs ...
Tree height is an important indicator of a forest’s maturity and overall health. Forest restoration projects rely on tree height as a predictor and measurement of success, but forecasting a forest’s future tree height based on observations alone is almost impossible. There are too many factors that contribute to the growth and health of trees.
Because so many factors can impact how a tree develops, researchers enhanced a predictive model called the Allometric Scaling and Resource Limitations (ASRL) model and then deployed it using ...
The Indian River Lagoon was considered one of the last “unpolluted coastal lagoons” in Florida in the 1970s. Fast forward to today and most of the 156-mile lagoon is now considered impaired because of external sources of nutrients including human waste, fertilizers, stormwater runoff, agriculture, rainfall and sub-marine groundwater discharge.
As a result, the lagoon – especially the Northern Indian River Lagoon and Banana River – has experienced various harmful algal blooms, catastrophic seagrass losses, and is the epicenter of Florida ...
Polycyclic aromatic hydrocarbons (PAHs) removal in the soil environment is of great significance for repairing the long-term damaged ecosystem. However, the poor mass transfer process and low catalytic activity in most conventional methods lead to limited removal efficiency. A team of scientists has constructed a gradient F-doping hydroxyapatite core-shell structure (HAP@FAP) with the coupling effect of flexoelectricity and piezoelectricity for degradation of PAHs in soil that provide innovative approaches for soil remediation. Their work was published in the journal Industrial Chemistry & Materials in October 2023.
The poor mass ...
The Daniels Lab at the Florida Museum of Natural History was recently awarded two grants to help support pollinators in Florida. The Florida Department of Transportation has set aside $155,002 for the team to plant and monitor thousands of milkweeds along roads in North Florida, and Duke Energy Florida will distribute $144,421 over three years to evaluate the establishment of pollinator habitat at its new solar site Alachua County.
Pollinators are declining on a global scale, the collateral damage of continued habitat destruction and urbanization, among other stressors. ...
For decades, corn and soy farmers have heavily relied on one herbicide: glyphosate. Crops bred to resist glyphosate have been extremely successful, with over 90% of corn and soy hectares planted with glyphosate-resistant varieties by 2014. But as Christopher Landau and colleagues document, the chemical was not quite the “silver bullet” it was promised to be. With an entire industry using the same chemical—the US and Canada alone apply more than 130 million kg annually—evolutionary selection pressures on weed plants have been intense. Since 1996, there have been 354 confirmed cases of glyphosate ...
In a study on fruit flies, daily low-intensity blue light exposure (BLE), similar to that experienced daily by billions of humans in the form of LED lighting and device screens, changed flies at the sub-cellular level, affecting processes related to aging and circadian rhythms. Xiaoyun Wang and colleagues exposed fruit flies (Drosophila melanogaster) to different durations of daily low-intensity BLE and then analysed the consequences to the cellular makeup of the insects, as compared to flies raised in darkness. The authors paid particular attention to ...
A study links hostility on Wikipedia to lost productivity on the site. Wikipedia, the largest reference work ever created, is written and edited by tens of thousands of volunteers, known as Wikipedians. Despite the fact that anyone can edit any page, studies show that Wikipedia is generally a reliable source of information. Ivan Smirnov and colleagues studied how the volunteer labor that keeps the site working is affected by hostile comments in the “user talk” pages connected to each editor. Toxic comments were identified by a toxicity detection algorithm devised by the Perspective API ...
