Follow-up Studies of Primary Snoring(PS) and Obstructive Sleep Apnea Hypopnea Syndrome(OSAHS) in Chinese Children

July 19, 2022 updated by: Zhifei Xu, Beijing Children's Hospital

Follow-up Studies of PS and OSAHS in Chinese Children

The study is designed to investigate the natural course of Primary snoring in 1-2 years or more and the different effect of drug and surgical treatment applied in children with obstructive sleep apnea (OSAS) by comparing the polysomnography(PSG) and sleep questionaires in 6 months after treatment.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The evolution of snoring and OSAS in children is not well established since few studies have been published.This study is designed to evaluate the evolution of primary snoring and OSAS in children who had been submitted to watchful waiting 、drug or adenotonsillectomy.The participated children will be evaluated by full physical examination and nocturnal polysomnography(PSG), after which they were divided into 2 groups: apnea and snoring. After 6 months following the initial evaluation, patients were submitted to a new nocturnal polysomnography, and all data were compared to those of the first examination.And after 3 months and 12 months following the initial evaluation, patients will be called to complete the sleep questionnaire.Then analyse the change of parameters of polysomnography after 6 months of follow-up,and describe the changes of items of sleep questionnaire.

Study Type

Observational

Enrollment (Actual)

500

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Beijing, China, 100045
        • Sleep Center,Beijing Children's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

3 years to 12 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

PS and OSAHS in Chinese children

Description

Inclusion Criteria:

  • Children aged 3-12 yrs, who are referred for clinical evaluation of habitual snoring and who were scheduled for an overnight polysomnogram.

Exclusion Criteria:

  • Children who are suffered from any chronic medical or psychiatric condition
  • Children with acute respiratory infection
  • Children with severe craniofacial deformities
  • Children with cardiopulmonary diseases
  • Children with a genetic syndrome that was known to affect cognitive abilities, or are receiving medications that are known to interfere with memory or sleep onset or heat rate

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Surgery
Adenotonsillectomy
Adenotonsillectomy
Conservative treatment
Mometasone Furoate Aqueous Nasal Spray or uticasone propionate (1/once qd) and(or)Leukotriene antagonists(4 or 5mg/once qn) or H1 receptor antagonists
Mometasone Furoate Aqueous Nasal Spray or uticasone propionate (1/once qd) and(or)Leukotriene antagonists(4 or 5mg/once qn) or H1 receptor antagonists
no treatment
just regular follow-up
just regular follow-up

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The changes of PSG parameters of children with PS or OSAS
Time Frame: 6 months
In our study, there are 55 children of mild to moderate SDB with conservative treatment, among which 23 children are chosen in PS group and 32 children are chosen in OSAS group. For PSG, according to the value of OAHI to determine the improvement of the child, the value of OAHI is decreased by ≥ 25% for improvement. In the PS group, there were 2 cases with improvement, and the corresponding remission rate was 8.7%. In the OSAS group, there are 22 cases with improvement, and the corresponding remission rate was 68.8%. There was a significant difference between the remission rate of PS group and that of OSAS group (P<0.001).
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The changes of sleep questionnaires of children with PS or OSAS
Time Frame: 3 months, 6 months, 12 months

There are five impact factors in the PSQ questionnaire, including: 1) nighttime snoring related symptoms (S); 2) sleep accompanying symptoms and related diseases (A); 3) daytime sleepiness related symptoms (L); 4) behavior related symptoms (B); and 5) others' evaluation of children's sleep (O).

In the PS group, there were significant difference for factor S, A and B at the time of 3 months and one year. For factor L, there was significant change at 3 months, while there was no significant change at half the year and one year.

In the OSAS group, there was significant change in the S factor for 3 months, half the year, and one year. While for the O factor, there was no significant change in any time. For factor A and L, there was a significant change in 3 months and one year. For the B factor, there was a significant difference at one year.

3 months, 6 months, 12 months
The changes of level of leukotriene in urine of children with PS or OSAS
Time Frame: 6 months
There was no significant difference in the level of leukotriene between PS and OSAS group. Also no significant difference in the level of leukotriene was detected among waiting, conservative or surgery group.
6 months
The high-sensitivity CRP and Heart rate variability (HRV) of children with SDB
Time Frame: 0 months
The controls were elder. Children in moderate-severe OSAS group were more boys and more obese. Because of the disease itself, there was statistic difference in AHI, OAI, ODI, respiratoryrelatedarousal index (ArI-resp), average SpO2 and lowest SpO2 among groups.The percentage of high level hs-CRP varied with the severity of SDB and cochran armitage trend test showed statistical significance (Z=-2.5109, p=0.012). In logistic regression analysis, OSAS, otitis media and BMI-z score were independent risk factors for high level hs-CRPafter adjusting for age and gender( p<0.0001). In multiple linear regression,after removing theconfounding factor of OSAS, it showed that high level hs-CRP was negatively correlated with SDNN, RMSSD, LF and HF respectively (p=0.003, p<0.001, p=0.007 and p=0.003 respectively).
0 months

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
The pictorial memory task acquisition and retention in children with SDB
Time Frame: 0 month
There was no significant difference in the score of pictorial-based memory task among the control, PS and OSAS groups .Conclusion : Compared with the control group, both PS and OSAS group have abnormal sleep structure and respiratory parameters whereas no significant difference in the score of pictorial-based memory task .We couldn't demonstrate that sleep disordered breathing can affect children's ability of learning picture from the pictorial-based memory task in our study.
0 month
The endothelial cell function in children with PS or OSAS
Time Frame: 0 month

Both mild and moderateesevere OSA groups had lower RHI than PS (P < 0.001, P=0.001, respectively). Linear regression analysis revealed that RHI was positively correlated with age (r=0.17, P=0.002), BMI z score (r=0.14, P=0.008) and oxygen saturation nadir (r=0.15, P=0.006), but negatively correlated with oxygen desaturation index (ODI3%; r=0.19, P=0.001) and respiratory related arousal index (ArI-resp) (r=0.24, P < 0.001). In stepwise regression analysis, age, BMI z score, and ArI-resp were independently associated with endothelial function (r=0.34, P < 0.001).

Conclusion: Children with OSA are at increased risk for abnormal endothelial function than habitually snoring children. Furthermore, in addition to age and BMI, which are well-established factors affecting endothelial function, both intermittent hypoxia and sleep fragmentation during sleep also emerge as candidate risk factors contributing to endothelial dysfunction in snoring children

0 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Director: Xu Zhifei, MD,PhD, Beijing Children's Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2014

Primary Completion (Actual)

June 1, 2022

Study Completion (Actual)

July 1, 2022

Study Registration Dates

First Submitted

May 13, 2015

First Submitted That Met QC Criteria

May 14, 2015

First Posted (Estimate)

May 19, 2015

Study Record Updates

Last Update Posted (Actual)

July 21, 2022

Last Update Submitted That Met QC Criteria

July 19, 2022

Last Verified

July 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • BCH-OSAHS-002

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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