Diagnosing Kids’ Sleep Apnea in a Cup
When an adult snores, it’s annoying. When a kid snores, it’s mostly cute. But as David Gozal, chairman of pediatrics at Comer Children’s Hospital explains, those nighttime noises aren’t always innocuous.
“Snoring is not benign in kids,” Gozal said. “Snoring is clearly something that we need to not just make fun of but actually think that it has consequences on learning, behavior, the cardiovascular system, and diabetes. It can also exacerbate many existing conditions associated with learning, intelligence and behavior.”
“Those effects are silent for the most part in children, but nevertheless, if let go for a long time, they can cause damage that could be irreversible and lead to onset of disease in adults earlier and more severe than otherwise would be appropriate.”
Yet while awareness and diagnosis of sleep disorders in adults has improved over recent years, the pediatric end of the field has lagged somewhat behind. Conducting an overnight sleep study - which involves a night in the hospital or sleep center bed attached to a multitude of wires - is unpleasant enough for adults; just try performing one on a sleep-deprived 8-year-old. The number of sleep technicians and doctors trained to record and analyze the unique characteristics of sleep in children is also a fraction of those available for adult studies, Gozal said. That means very few sleep centers are able to conduct sleep studies in children, which produces waiting lists as long as one year in some areas.
And yet, better screening technology is needed to sort out relatively harmless “primary snoring,” seen in around 1 out of every 10 kids, from the more harmful obstructive sleep apnea (OSA). Often associated with adult, overweight males, OSA reflects the occurrence of frequent breathing “pauses” during sleep, which may lead to as many as hundreds of short episodes without oxygen and abrupt awakenings during a single night of sleep. Gozal’s research found that about 3 percent of children suffer from OSA, but the condition is often undiagnosed, and sometimes even treated (through surgical removal of the tonsils and adenoids) based upon mere reports of chronic snoring.
“This is not a trivial proposition,” Gozal said. “And yet because there’s so little choice, parents and physicians decide to pursue surgery because there’s not enough access to the diagnostic tool. If it were easy, and not as expensive and inconvenient, it would allow everybody to get tested and know whether you have sleep apnea or you don’t before going to surgery.”
That’s the kind of clinical problem that inspires creative science, and Gozal’s research group at his old home, the University of Louisville, and his new, the University of Chicago, have been working toward a simpler way of testing children for obstructive sleep apnea. Recognizing that OSA causes changes in kidney function in mice and humans, Gozal hypothesized that kids with sleep apnea could be identified due to differences in what comes out of their kidney: urine. By measuring the proteins from kids diagnosed with OSA and comparing their “urinary proteome” to kids without the sleep disorder, Gozal’s team hoped to identify candidate proteins that could be used in, simply put, a pee test for sleep apnea.

First of all: OUCH.
The death of Michael Jackson has made its expected transition from a celebration of his life and music to an uncomfortable public autopsy of how he died. More than a month after his death, the official coroner’s autopsy has yet to be officially released, but various media outlets have sniffed out one particular drug that is expected to appear in the pop star’s toxicology report: the general anesthetic propofol.
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