This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Children with FTT are not at present routinely evaluated for obstructive sleep disturbance (OSD), although sleep disorders may be an underappreciated risk for FTT. The presence of OSD and its severity can be measured with polysomnography, a study that measures a number of parameters during sleep. Mood and behavior problems, bed- wetting, and academic performance have all been linked to OSD in childhood. OSD can also lead to health consequences as severe as heart failure and death. Literature also supports that through complex physiology, OSD is also related to FTT, and may even be the cause of growth failure in some children.Our hypothesis is twofold: 1) the prevalence of OSD is higher in children with FTT than in the general pediatric population2) the adenoid and tonsil surgery most commonly used to correct the OSD in children will result in improvements in the growth rates of these same children with FTT. This will be accomplished by a study of children aged 12-60 months with FTT, using parental questionnaire, physical exam, formal polysomnography, and medical record monitoring in children who qualify for and undergo adenotonsillectomy surgery. We plan to determine the prevalence of obstructive sleep apnea in a cross-sectional population of children with failure to thrive. If we can demonstrate that in children with both FTT and OSD grow better after correction of their sleep disturbance, then a large number of children with FTT could be better diagnosed and treated, for improved growth and brighter futures.
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