Sleep Disorder Shares Blame for Early Type 2 Diabetes

Type 2 diabetes early in life is commonly associated with obesity, but in many cases there may be another factor at play. Obstructive sleep apnea, a common untreated sleeping disorder in teens, can contribute to the onset of diabetes.

A study in the September issue of SLEEP reports sleep apnea worsens insulin resistance. Insulin resistance is a risk factor for type 2 diabetes as well as metabolic syndrome.

The link between sleep apnea and insulin resistance wasn’t fully clear until now. The presence of obesity and the onset of puberty complicated the relationship.

The study involved a group of 98 obese children of both genders. About half of the participating children had signs of sleep apnea.

Children were recruited from two age groups: pre and post puberty.
Each child was screened for obstructive sleep apnea using an overnight sleep study, and assessed for insulin resistance.

Results show children who tested positive for sleep apnea had worse insulin resistance, thus were at higher risk for type 2 diabetes and metabolic syndrome.

Sleep apnea isn’t the only sleep disorder that can lead to diabetes. A past study shows severe sleep loss from long-term insomnia can also worsen insulin resistance.

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My Child Snores, is it Sleep Apnea?

Snoring is especially prevalent in adults and a surprising number of their children also “saw logs.” Sleepeducation.com reports between 10 and 20 percent of American children snore. Children in China have similar snoring rates, a study included in the September issue of the journal Chest reports.

A survey of more than 6,000 school-aged kids found approximately 1 in 10 Chinese children snore habitually. Results show kids who snore have a parent who snores. Male gender and obesity also promote snoring. Kids with allergies or a history of upper respiratory infections tend to snore loudly.

A history of loud snoring can be a red flag for childhood OSA. Obstructive sleep apnea is also a problem for about 2 percent of healthy young children. One way to tell if your child has OSA is to if the child also appears to be working hard to breathe while asleep.

One of the main indicators of sleep apnea in teenagers or adults – daytime fatigue – is not always present for kids. Unlike older patients, children with OSA often do not wake up during breathing pauses leading to more normal sleeping patterns.

The primary treatment for children who snore or have OSA is different compared to adults. Children often have their tonsils and adenoids removed to increase the size of the airway. Most often children are able to breathe normally after this procedure.

When an adenotonsillectomy doesn’t solve sleep apnea many children choose child-sized CPAP masks to keep the airway open. Oral appliances and weight loss are two other options for children with sleep apnea.

If your child snores, find out if its sleep apnea by scheduling an appointment for an overnight sleep study at an AASM accredited sleep center.

Image by BostonTx

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Sleep apnea in kids predicts lower grades, behavioral problems

Obstructive sleep apnea is a not only a health risk for children, it’s a barrier to academic success. Schoolchildren with moderate to severe sleep-disordered breathing averaged a half a grade lower than their peers. Those same children are also prone to behavioral problems according to an abstract presented Tuesday at SLEEP 2010.

None of the children with OSA brought home report cards with an “A” average. 30 percent had a “C” average or lower. Roughly 15 percent of their peers who didn’t have OSA scored “A” averages. Only 15 percent posted average or below average grades.

The findings were regardless of race, gender, socioeconomic status and sleep duration on school nights.

Testing suggests an association between OSA and inattention and poor study skills in real-world situations. There was no significant link to neurobehavioral functions such as intelligence, memory and problem solving.

163 overweight children participated in the study. That group was chosen because excessive weight is a risk factor for the disorder. OSA diagnoses were made based on report by parents and an overnight polysomnography.

Moderate to severe OSA was defined by an apnea-hypopnea index of more than five breathing pauses per hour of sleep. About half the children had OSA.

The children and their parents gave their grades to the researchers. Teachers and parents reported behavioral concerns. Office-based neuropsychological testing was used to assess children’s neurobehavioral functioning.

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Obese kids more at risk for snoring, obstructive sleep apnea, says Italian study

Childhood obesity carries a lot of risks, especially later in life, and new research shows it can affect sleep early on.

A new study suggests kids who are significantly overweight are twice as likely to have obstructive sleep apnea. Those who don’t are even more prone to snore loudly. The results were published in the May issue of the journal Chest.

Italian researchers compared more than 800 elementary school- or preschool-aged children in Southern Italy. The study divided them into three groups based on their answers to a questionnaire about snoring.

Scientists classified 5.4 percent of the children as habitual snorers. 17 percent occasionally snored. A vast majority – 77.5 percent – did not snore at all.

The habitual snorers received screenings for obstructive sleep apnea. Only 14 children had the sleep disorder.

The researchers calculated each child’s body mass index (BMI) based on Italian growth charts. About 8 percent of the children were obese. 15 percent were overweight.

Through statistical analysis, it turned out 12.5 percent of obese children snored regularly. Only 4.6 percent of normal-weight children were considered habitual snorers.

3.1 percent of obese children included in the study had obstructive sleep apnea. That’s twice many as their peers.

These findings are counter to previous research published in the Journal of Clinical Sleep Medicine and reported in the Sleepeducation blog. An Australian study concluded obesity increased the risk for obstructive sleep apnea for teens but not younger children.

Obstructive sleep apnea is a serious disorder and the symptoms can be mistaken for common snoring. Children with OSA often appear to struggler to breath during sleep, with obvious pauses and gasps for breath.

Two percent of healthy young children have OSA, according to the American Academy of Sleep Medicine.

Learn more about obstructive sleep apnea in children or snoring. Get help at an AASM-accredited sleep center near you.

Image courtesy Angela Wylie, Melbourne Sunday Age

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Ear Tubes, Snoring & Sleep Apnea in Children

A recent study examined the risk of sleep-disordered breathing in children who had ear tubes inserted.

The study from Israel involved 352 children with ear tubes. Another 105 children were included as controls. Parents were interviewed by phone.

Results show that sleep-disordered breathing was common in children who had ear tubes inserted. Twenty-two percent of parents reported that their child snores.

Tonsils had been removed from 18 percent of children with ear tubes. This surgery is a common treatment for obstructive sleep apnea in children. Thirty-four percent of children snored or had their tonsils removed after the ear tubes were inserted.

Children with ear tubes were four times more likely than controls to have future tonsil removal. Their risk for snoring was three times higher.

The authors reported that sleep-disordered breathing shares common mechanisms with Eustachian tube dysfunction. This tube extends from the middle ear to the throat.

They concluded that children who need ear tubes inserted are at risk for sleep-disordered breathing. Doctors should regularly check these children for symptoms of sleep apnea. This will allow for early detection and treatment.

MedlinePlus reports that ear tube insertion helps relieve fluid buildup behind a child’s eardrum. The tubes allow the fluid to drain so that the ears can function normally. Another name for the procedure is “tympanostomy tube insertion.”

It may be recommended when excess fluid in the ear does not go away after four months or longer. Tubes also may be inserted if an ear infection does not go away or if a child has many ear infections.

The AASM reports that about two percent of healthy young children have OSA. It occurs when soft tissue in the back of the throat collapses and blocks the airway during sleep.

Most children with OSA have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

Read more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Image by Travis Isaacs

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Targeting Tonsils to Treat Child Sleep Apnea

A new study examined the genetic basis of enlarged tonsils in children with obstructive sleep apnea.

The study involved 18 children with OSA. They were compared with 18 children who had recurrent tonsillar infections. All of the children had surgery to remove their tonsils. Then the tonsil tissue from each child was analyzed.

"We found that in the tonsil tissues of children with OSA, certain genes and gene networks were over expressed," study co-author Dr. David Gozal said in a news release.

They found that children with OSA had higher levels of a protein called phosphoserine phosphatase (PSPH). This protein almost never appeared in the tonsils of the children who did not have OSA.

Then they experimented with a phosphatase inhibitor to block this protein. It reduced the cell proliferation and increased programmed cell death.

"Together, these observations suggest that PSPH is a logical therapeutic target in reversing adenotonsillar enlargement in pediatric OSA," said Gozal.

Recently Gozal reported that the urine concentrations of certain proteins were altered in children with OSA. The results suggested that a urine teat may be able to detect sleep apnea in children.

The AASM reports that about two percent of healthy young children have OSA. It occurs when soft tissue in the back of the throat collapses and blocks the airway during sleep.

Most children with OSA have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

Last year the Sleep Education Blog reported that the causes of sleep apnea in children are complex. Sleep apnea often occurs when a child has large tonsils and adenoids. But weight and nasal problems also can play a role.

Removing the tonsils is a common treatment for sleep apnea in children. But some children may continue to have OSA even after the procedure.

Read more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

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Sleep Apnea & Obesity in Children and Teens

A new study shows that teens were more likely to have obstructive sleep apnea if they were overweight or obese. But obesity did not increase the risk for OSA in younger children.

The results were published today in the Journal of Clinical Sleep Medicine.

The Australian study involved 234 Caucasian children. They were between the ages of 2 and 18 years. Their height and weight were used to calculate their body mass index. About 62 percent of the children were boys.

The children were suspected to have possible OSA because of parental concerns about their snoring. Their sleep was evaluated during an overnight sleep study.

Results show that the risk for OSA increased 3.5 times for each increase in BMI score in children 12 years of age and older. But increases in BMI score did not raise the risk for OSA in children under the age of 12.

OSA was detected in 34 percent of the children who were between 12 and 18 years of age. About 53 percent of the children in this age group were obese.

The authors suggest that developmental changes during adolescence may explain the results. These changes include reductions in the muscle tone of the upper airway.

They emphasized that the results are specific to Caucasian children. Obesity and OSA may interact at other ages in other ethnic groups.

The authors also noted that tonsil size may interact with obesity to increase the risk of developing OSA. But snoring teens who are obese should be evaluated for OSA regardless of their tonsil size.

The AASM reports that about two percent of healthy young children have OSA. It occurs when soft tissue in the back of the throat collapses and blocks the airway during sleep.

Most children with OSA have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

In June the Sleep Education Blog reported that the causes of sleep apnea in children are complex. Sleep apnea often occurs when a child has large tonsils and adenoids. But weight and nasal problems also can play a role.

Learn more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Image by Robert Hruzek

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Urine Test May Detect Sleep Apnea in Children

A new study shows that obstructive sleep apnea in children is associated with alterations in urinary concentrations of specific protein clusters.

The study evaluated morning urine proteins. It involved 60 children with OSA. They were compared with 30 children who have primary snoring and 30 controls.

The researchers found that the urine concentrations of 16 proteins were altered in children with OSA. Further analysis identified four proteins that have “favorable predictive properties.”

Using cutoff points for these biomarkers they correctly identified 95 percent of the children with OSA. This approach also produced no false-positive results.

"It was rather unexpected that the urine would provide us with the ability to identify OSA," lead author Dr. David Gozal said in a press release. “"These findings open up the possibility of developing a relatively simple urine test that could detect OSA in snoring children.”

Gozal would like to develop a color-based test that could be done in a doctor’s office or by the parents. But first the results need to be confirmed in a larger sample of children from around the country.

About two percent of young children have sleep apnea. In June the Sleep Education Blog reported that the causes of sleep apnea in children are complex.

Sleep apnea often occurs when a child has large tonsils and adenoids. But weight and nasal problems also can play a role.

Most children with sleep apnea have a history of snoring. It tends to be loud and may include obvious pauses in breathing and gasps for breath.

In October the Sleep Education Blog reported that sleep apnea affects heart rate and blood pressure in children. Another study found a high “sibling risk” of OSA in both boys and girls.

Learn more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Image by Catherine

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