LETICIA MARIA SANTORO FRANCO AZEVEDO SOSTER
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/63, Hospital das Clínicas, Faculdade de Medicina
LIM/63, Hospital das Clínicas, Faculdade de Medicina
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- Attention deficit hyperactivity disorder and restless leg syndrome across the lifespan: A systematic review and meta-analysis(2023) MIGUEIS, D. P.; LOPES, M. C.; CASELLA, E.; SOARES, P. V.; SOSTER, L.; SPRUYT, K.This systematic review aims to assess the association between attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS) in accordance with the Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were searched for original articles that reported prevalence data on ADHD and RLS until January 24th, 2023. Two independent reviewers evaluated the quality of the articles using the National Institutes of Health assessment tool. Among the 208 articles identified between 1996 and 2022, 29 were included. In large general population studies, 2.6-15.3% of participants met the RLS criteria, of which 3.2-17.4% presented with ADHD. In the ADHD group, RLS symptoms ranged from 11 to 42.9% in children and 20-33.0% in adults. This suggests a strong co-occurrence between RLS and ADHD. A common characteristic of these conditions is sleep fragmen-tation, as discussed in the reviewed papers. Although large-scale studies with comparable diagnostic criteria across the lifespan are required, our findings may advocate a possible common physiological pathway, including sleep fragmentation and dopaminergic system impairment.(c) 2023 Elsevier Ltd. All rights reserved.
- SLEEP DISORDER, CHOREA, AND DEMENTIA ASSOCIATED WITH IgLON5 ANTIBODIES(2015) SIMABUKURO, Mateus M.; SABATER, Lidia; ADONI, Tarso; CURY, Rubens Gisbert; HADDAD, Monica Santoro; MOREIRA, Camila Hohi; OLIVEIRA, Imam; BOAVENTURA, Mateus; ALVES, Rosana Cardoso; SOSTER, Leticia Azevedo; NITRINI, Ricardo; GAIG, Carles; SANTAMARIA, Joan; DALMAU, Josep; GRAUS, Francesc
- Proposed management model for the use of telemonitoring of adherence to positive airway pressure equipment - position paper of the Brazilian Association of Sleep Medicine - ABMS(2021) VIDIGAL, T. De Aguiar; BRASIL, E. L.; FERREIRA, M. N.; MELLO-FUJITA, L. L.; MOREIRA, G. A.; DRAGER, L. F.; SOSTER, L. A.; GENTA, P. R.; POYARES, D.; HADDAD, F. L. M.This document ""Proposed management model for the use of telemonitoring to positive airway pressure adherence"" was prepared by a special commission of the Brazilian Association of Sleep Medicine, with the objective of recommending a follow-up model for patients undergoing positive airway pressure therapy using telemonitoring. This proposal was prepared based on a survey and analysis of the most up-to-date national and international literature and uses the best available evidence to facilitate the standardization of care by Sleep Science specialists with potential benefit for patients. Among the conclusions of the document, it is emphasized that telemonitoring is an important tool that allows health professionals trained in sleep-disordered breathing to remotely monitor PAP therapy, allowing prompt and, when necessary, daily adjustments to be made in order to increase adherence to treatment. The authors also conclude that the privacy of the data received and shared during the provision of telemonitoring must be respected by the physician or health professional trained in sleep, with the authorization of the patient and/or person responsible, who should be made aware of the short-, medium- and long-term provision of the service. © 2021 Brazilian Association of Sleep and Latin American Federation of Sleep Societies. All rights reserved.
- Clinical and anatomical characteristics associated with obstructive sleep apnea severity in children(2022) BOZZINI, Maria Fernanda; FRANCESCO, Renata C. Di; SOSTER, Leticia A.Purpose: To determine the clinical and anatomical characteristics associated with obstructive sleep apnea severity in children with adenotonsillar hypertrophy.Methods: The authors conducted a cross-sectional multidisciplinary survey and selected 58 Brazilian children (4- 9 years old) with adenotonsillar hypertrophy, parental complaints of snoring, mouth-breathing, and witnessed apnea episodes. The authors excluded children with known genetic, craniofacial, neurological, or psychiatric conditions. Children with a parafunctional habit or early dental loss and those receiving orthodontic treatment were not selected. All children underwent polysomnography, and three were excluded because they showed an apneahypopnea index lower than one or minimal oxygen saturation higher than 92%. The sample consisted of 55 children classified into mild (33 children) and moderate/severe (22 children) obstructive sleep apnea groups. Detailed clinical and anatomical evaluations were performed, and anthropometric, otorhinolaryngological, and orthodontic variables were analyzed. Sleep disorder symptoms were assessed using the Sleep Disturbance Scale for Children questionnaire. All children also underwent teleradiography exams and Rickett's and Jarabak's cephalometric analyses.Results: The mild and moderate/severe obstructive sleep apnea groups showed no significant differences in clinical criteria. Facial depth angle, based on Ricketts cephalometric analysis, was significantly different between the groups (p = 0.010), but this measurement by itself does not express the child's growth pattern, as it is established by the arithmetic mean of the differences between the obtained angles and the normal values of five cephalometric measurements.Conclusions: The clinical criteria and craniofacial characteristics evaluated did not influence the disease severity.
- Reduction in Parasympathetic Tone During Sleep in Children With Habitual Snoring(2019) LOPES, Maria-Cecilia; SPRUYT, Karen; AZEVEDO-SOSTER, Leticia; ROSA, Agostinho; GUILLEMINAULT, ChristianIntroduction: Changes in the autonomic nervous system due to Obstructive Sleep Apnea (OSA) during the life span have been described. Some pediatric studies have shown cardiovascular effects in children who do not fit the criteria for OSA; namely children with mild sleep disordered breathing. Objective: We investigated heart rate variability (HRV) during sleep in children with chronic snoring and flow limitation events during sleep. Methods: Ten children and adolescents with chronic snoring and an apnea hypopnea index < 1, associated to high Respiratory Index, and 10 controls matched for age, gender, and Tanner stage were monitored following one night of habituation in the sleep laboratory. HRV was studied at each sleep stage. The time and frequency domains were calculated for each 5-min period. Results: All patients were chronic heavy snorers. They presented an apnea hypopnea index = 0.8, respiratory disturbance index = 10.2/h with lowest O2 saturation 96.1 +/- 2.4%. The total power of HRV was decreased in all stages (p < 0.05). There was also a decrease in NN50 and pNN50 during all sleep stages compared to healthy controls (p = 0.0003 and p = 0.03, respectively). Conclusion: A reduction in parasympathetic tone was found in the patient group. This may represent an autonomic impairment during sleep in children with mild SDB. A reduction in HRV in children with habitual snoring could be associated with possible increases in cardiovascular risk in adulthood. Significance: The study indicates that children with habitual snoring have important parasympathetic tone changes during sleep.