RESUMEN
Sleep is a key component of life to maintain our health, performance, safety and quality of life. In fact, sleep has been implicated in the optimal functioning of all organ systems - brain, heart, lung, metabolism, immune function, and hormonal balance too. One of the most common reasons for poor-quality sleep in children is a group of conditions termed sleep disordered breathing (SDB). Obstructive sleep apnea (OSA) is the most severe form of SDB. A good history and clinical examination is likely to reveal features of SDB including snoring, restless sleep, morning sleepiness, irritability or exhibit signs of hyperactivity. Examination may also reveal evidence of underlying pathology e.g., Craniofacial abnormalities, obesity and neuromuscular disorders that creates higher risk of developing SDB. Further investigation using polysomnography (PSG) is considered a gold-standard assessment of SDB and allows for scoring using Obstructive Apnoea-Hypopnea scale. Adenotonsillectomy is used as the first-line management in patients who otherwise have normal anatomy. Parents often approach their pediatricians with concerns regarding their child's sleeping habits and given the significant role sleep has on child development, it is essential that doctors are equipped to provide good care and advice for this population. This article aims to summarise presentation of SDB and common risk factors, investigations and management options to aid clinicians in managing SDB.
RESUMEN
OBJECTIVE: To assess the association of ethnicity and birthplace on emotional and psychosexual well-being in women with polycystic ovary syndrome (PCOS). DESIGN: Cross-sectional study. SETTING: Community recruitment via social media campaigns. POPULATION: Women with PCOS completing an online questionnaire in September-October 2020 (UK) and May-June 2021 (India). METHODS: The survey has five components, with a baseline information and sociodemographic section followed by four validated questionnaires: Hospital Anxiety and Depression Scale (HADS); Body Image Concern Inventory (BICI); Beliefs About Obese Persons Scale (BAOP); and Female Sexual Function Index (FSFI). MAIN OUTCOME MEASURES: We used adjusted linear and logistic regression models, adjusting for age, education, marital status and parity, to evaluate the impact of ethnicity and birthplace on questionnaire scores and outcomes (anxiety and/or depression, HADS ≥ 11; body dysmorphic disorder (BDD), BICI ≥ 72). RESULTS: A total of 1008 women with PCOS were included. Women of non-white ethnicity (613/1008) reported higher rates of depression (OR 1.96, 95% CI 1.41-2.73) and lower BDD (OR 0.57, 95% CI 0.41-0.79) than white women (395/1008). Women born in India (453/1008) had higher anxiety (OR 1.57, 95% CI 1.00-2.46) and depression (OR 2.20, 95% CI 1.52-3.18) but lower BDD rates (OR 0.42, 95% CI 0.29-0.61) than women born in the UK (437/1008). All sexual domains, excluding desire, scored lower for non-white women and women born in India. CONCLUSIONS: Non-white women and women born in India reported higher emotional and sexual dysfunction, whereas white women and women born in the UK reported higher body image concerns and weight stigma. Ethnicity and birthplace need to be considered for tailored, multidisciplinary care.