S15 Perceptions of sleep and the consequences of sleep disordered breathing in children: An international perspective

S15 Perceptions of sleep and the consequences of sleep disordered breathing in children: An international perspective
Sunday, April 29 | 2:30pm-4:00pm | Room Bordeaux

Chair: Rosemary Horne (Australia)

2:30pm – 2:32pm
Introduction
Rosemary Horne (Australia)

2:32pm – 2:52pm
Examining sleep practices from both a parent and child perspective
Dawn Elder (New Zealand)

2:52pm – 3:12pm
Cerebral blood flow response to hypercapnia in children with Obstructive Sleep Apnoea Syndrome
Ignacio Tapia (USA)

3:12pm – 3:32pm
Relationship between regional brain tissue changes and outcomes in children with sleep disordered breathing
Rosemary Horne (Australia)

3:32pm – 3:52pm
Randomised control study of the effects of adenotonsillectomy on blood pressure in children with OSA
Kate Chan (China)

3:52pm – 4:00pm
Question and Answer
Rosemary Horne (Australia)


Summary of symposium:
During childhood sleep is at a life time maximum. Sleep is essential for normal development and is particularly important in childhood when around 50% of each 24 hours is spent sleeping. Sleep disordered breathing occurs in up to 35% of children and has significant effects on daytime functioning including behaviour, maintenance of attention, memory and school performance. Sleep disordered breathing is also associated with adverse effects on the cardiovascular system, including elevated blood pressure. This symposium will discuss cross-cultural influences on sleep in childhood, the effects of sleep disordered breathing on the brain and how these effects are related to outcomes and whether treatment can improve these.

Prof Elder will report on the views of Maori and New Zealand European children about sleep which will be compared with objective measures of sleep (actigraphy) and parent reports of sleep problems and perceptions of their children’s sleep. Cultural differences between the two groups will be explored and discussed.

Dr Tapia will present findings of a study of cerebral blood flow changes elicited by hypercapnia and measured by direct correlation spectroscopy in children with and without sleep disordered breathing. Associations with neurobehavioral measures will be discussed.

Prof Horne will present findings of a recent MRI study using diffusion tensor imaging to relate brain tissue changes to blood pressure, cognitive, and behavioural outcomes in children with various severities of sleep disordered breathing. As predominantly acute changes were identified it is suggested that treatment/resolution of sleep disordered breathing might resolve the injury. The findings that chronic changes occurred in the frontal cortices which mediate behavioural execution suggest that alternative or more aggressive interventions may be required to improve behaviour.

Dr Chan will discuss the findings of a recent RCT examining the effectiveness of adenotonsillectomy in normalising blood pressure abnormalities in children with sleep disordered breathing. Elevated blood pressure has been documented in children with sleep disordered breathing in multiple cross-sectional studies. Persistently raised blood pressure is a known risk factor for subsequent cardiovascular adverse events. First-line treatment for childhood sleep disordered breathing remains adenotonsillectomy but evidence for the effectiveness of reducing blood pressure is limited.

Learning Objectives:
Upon completion of this CME activity, participants should be able to understand:
1 The importance of sleep during childhood
2 The consequences of sleep disordered breathing on the brain
3 The effectiveness of treatment of sleep disordered breathing in reducing

Target Audience:
Clinicians, sleep researchers