Professor Karen Waters

Paediatrics & Child Health, Children's Hospital, Westmead

D06 - Blackburn Building
The University of Sydney
NSW 2006 Australia

T: +61 2 9845 3441
F: +61 2 9845 3396

Biographical details

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Research interests

There are three research themes for A/Prof Waters group:

1. clinical studies in obstructive sleep apnoea (OSA) in children. At present, our main focus is on treatment outcomes, but we continue to evaluate the morbidities associated with OSA in children.

2. SIDS (sudden infant death syndrome). Our focus over the past 10 years has been the neuropathology of the brainstem in SIDS and correlations with clinical history, particularly prone sleeping or cigarette smoke exposure. Our focus now is to pursue the associations with cigarette smoke exposure.

3. Respiratory physiology during early development and effects of intermittent (hypercapnic) hypoxia.

We use the piglet as a model in the physiology studies of intermittent hypoxia and also in our neuropathology studies.


2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008


  • Baguley, K., Cheng, A., Castro, C., Wainbergas, N., Waters, K. (2014), Is day stay adenotonsillectomy safe in children with mild to moderate obstructive sleep apnoea? A retrospective review of 100 patients. International Journal of Pediatric Otorhinolaryngology. 78(1), 71-74. [Abstract]
  • Machaalani, R., Ghazavi, E., Hinton, T., Waters, K., Hennessy, A. (2014), Cigarette smoking during pregnancy regulates the expression of specific nicotinic acetylcholine receptor (nAChR) subunits in the human placenta. Toxicology and Applied Pharmacology. 276(3), 204-212. [Abstract]
  • Smith, C., Walker, K., Badawi, N., Waters, K., Maclean, J. (2014), Impact of Sleep and Breathing in Infancy on Outcomes at Three Years of Age for Children with Cleft Lip and/or Palate. Sleep. 37(5), 919-925. [Abstract]


  • Ngiam, J., Balasubramaniam, R., Darendeliler, M., Cheng, A., Waters, K., Sullivan, C. (2013), Clinical guidelines for oral appliance therapy in the treatment of snoring and obstructive sleep apnoea. Australian Dental Journal. 58(4), 408-419. [Abstract]
  • Afsharpaiman, S., Saburi, A., Waters, K. (2013), Respiratory difficulties and breathing disorders in achondroplasia. Paediatric Respiratory Reviews. 14(4), 250-255. [Abstract]
  • Waters, K., Suresh, S., Nixon, G. (2013), Sleep Disorders in Children. The Medical Journal of Australia. 199(8), 31-35. [Abstract]
  • Machaalani, R., Hunt, N., Waters, K. (2013), Effects of changes in energy homeostasis and exposure of noxious insults on the expression of orexin (hypocretin) and its receptors in the brain. Brain Research. 1526, 102-122. [Abstract]
  • Hunt, N., Waters, K., Machaalani, R. (2013), Orexin receptors in the developing piglet hypothalamus, and effects of nicotine and intermittent hypercapnic hypoxia exposures. Brain Research. 1508, 73-82. [Abstract]
  • Waters, K., Kol-Castro, C., Varghese, A., Lam, L., Prelog, K., Cheng, A. (2013), Correlations between polysomnographic and lateral airway radiograph measurements in paediatric obstructive sleep apnoea. Journal of Paediatrics and Child Health. 49(6), 445-451. [Abstract]
  • Maclean, J., Tan, S., Fitzgerald, D., Waters, K. (2013), Assessing ventilatory control in infants at high risk of sleep disordered breathing: A study of infants with cleft lip and/or palate. Pediatric Pulmonology. 48(3), 265-273. [Abstract]
  • Heussler, H., Chan, P., Price, A., Waters, K., Davey, M., Hiscock, H. (2013), Pharmacological and non-pharmacological management of sleep disturbance in children: an Australian Paediatric Research Network survey. Sleep Medicine. 14(2), 189-194. [Abstract]
  • Bejjani, C., Machaalani, R., Waters, K. (2013), The dorsal motor nucleus of the vagus (DMNV) in sudden infant death syndrome (SIDS): Pathways leading to apoptosis. Respiratory Physiology & Neurobiology. 185(2), 203-210. [Abstract]
  • Daniel, M., Bailey, S., Walker, K., Hensley, R., Kol-Castro, C., Badawi, N., Cheng, A., Waters, K. (2013), Airway, feeding and growth in infants with Robin sequence and sleep apnoea. International Journal of Pediatric Otorhinolaryngology. 77(4), 499-503. [Abstract]
  • Waters, K. (2013), Sleep and Sleep Disorders in Adolescents. In: A Clinical Handbook in Adolescent Medicine. (pp.393-406).United States: World Scientific Publishing.
  • Caldwell, P., Waters, K. (2013), Nocturnal Enutesis. In: Oxford Handbook of Infant, Child, and Adolescent Sleep and Behavior. (pp.370-378).United States: Oxford University Press.


  • MacLean, J., Fitzsimons, D., Fitzgerald, D., Waters, K. (2012), The spectrum of sleep-disordered breathing symptoms and respiratory events in infants with cleft lip and/or palate. Archives of Disease in Childhood. 97(12), 1058-1063. [Abstract]
  • Tang, S., Machaalani, R., Waters, K. (2012), Expression of brain-derived neurotrophic factor and TrkB receptor in the sudden infant death syndrome brainstem. Respiratory Physiology & Neurobiology. 180(1), 25-33. [Abstract]
  • Sillence, D., Waters, K., Donaldson, S., Shaw, P., Ellaway, C. (2012), Combined Enzyme Replacement Therapy and Hematopoietic Stem Cell Transplantation in Mucopolysacharidosis Type VI. In: JIMD Reports - Case and Research Reports, 2011/2. (pp.103-106).Germany: Springer.


  • Machaalani, R., Say, M., Waters, K. (2011), Effects of cigarette smoke exposure on nicotinic acetylcholine receptor subunits α7 and β2 in the sudden infant death syndrome (SIDS) brainstem. Toxicology and applied pharmacology. 257(3), 396-404. [Abstract]
  • Trivedi, A., Waters, K., Suresh, S., Nair, R. (2011), Congenital central hypoventilation syndrome: four families. Sleep & breathing = Schlaf & Atmung. 15(0), 785-9. [Abstract]
  • Caldwell, P., Hensley, R., Machaalani, R., Cheng, A., Waters, K. (2011), How effective is adenoidectomy alone for treatment of obstructive sleep apnoea in a child who presents with adenoid hypertrophy?. Journal of Paediatrics and Child Health. 47(8), 568-571. [Abstract]
  • Cheng, A., Corke, M., Loughran-Fowlds, A., Birman, C., Hayward, P., Waters, K. (2011), Distraction osteogenesis and glossopexy for Robin sequence with airway obstruction. ANZ Journal of Surgery. 81(5), 320-325. [Abstract]


  • Machaalani, R., Kashi, P., Waters, K. (2010), Distribution of nicotinic acetylcholine receptor subunits alpha7 and beta2 in the human brainstem and hippocampal formation. Journal of chemical neuroanatomy. 40(3), 223-31. [Abstract]
  • Waters, K. (2010), Serotonin in the sudden infant death syndrome. Drug News & Perspectives. 23(9), 537-548. [Abstract]
  • Machaalani, R., Gozal, E., Berger, F., Waters, K., Dematteis, M. (2010), Effects of Post-Mortem Intervals on Regional Brain Protein Profiles in Rats using SELDI-TOF MS Analysis. Neurochemistry international. 57(6), 655-61. [Abstract]
  • Tang, S., Machaalani, R., Waters, K. (2010), Immunolocalisation of pro- and mature- brain derived neurotrophic factor (BDNF) and receptor TrkB in the human brainstem and hippocampus. Brain research. 1354, 1-14. [Abstract]
  • Relf, B., Larkin, E., Torres, C., Baur, L., Christodoulou, J., Waters, K. (2010), Genome-wide linkage of obstructive sleep apnoea and high-density lipoprotein cholesterol in a Filipino family: bivariate linkage analysis of obstructive sleep apnoea. Journal of sleep research. 19(2), 349-57. [Abstract]
  • Browne, C., Sharma, N., Waters, K., Machaalani, R. (2010), The effects of nicotine on the alpha-7 and beta-2 nicotinic acetycholine receptor subunits in the developing piglet brainstem. International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience. 28(0), 1-7. [Abstract]


  • Tang, S., Machaalani, R., Kashem, M., Matsumoto, I., Waters, K. (2009), Intermittent Hypercapnic Hypoxia Induced Protein Changes in the Piglet Hippocampus Identified by MALDI-TOF-MS. Neurochemical research. 34(12), 2215-25. [Abstract]
  • Maclean, J., Hayward, P., Fitzgerald, D., Waters, K. (2009), Cleft lip and/or palate and breathing during sleep. Sleep medicine reviews. 13(5), 345-54. [Abstract]
  • Machaalani, R., Say, M., Waters, K. (2009), Serotoninergic receptor 1A in the sudden infant death syndrome brainstem medulla and associations with clinical risk factors. Acta neuropathologica. 117(3), 257-65. [Abstract]
  • Maclean, J., Waters, K., Fitzsimons, D., Hayward, P., Fitzgerald, D. (2009), Screening for obstructive sleep apnea in preschool children with cleft palate. The Cleft palate-craniofacial journal. 46(2), 117-123. [Abstract]
  • Waters, K., Cheng, A. (2009), Adenotonsillectomy in the context of obstructive sleep apnoea. Paediatric Respiratory Reviews. 10(1), 25-31. [Abstract]


  • Tang, S., Machaalani, R., Waters, K. (2008), Brain-derived neurotrophic factor (BDNF) and TrkB in the piglet brainstem after post-natal nicotine and intermittent hypercapnic hypoxia. Brain research. 1232(1232), 195-205. [Abstract]
  • Robinson, P., Waters, K. (2008), Are children just small adults? The differences between paediatric and adult sleep medicine. Internal medicine journal. 38(0), 719-31. [Abstract]
  • Waters, K. (2008), Interventions in the paediatric sleep laboratory: the use and titration of respiratory support therapies. Paediatric respiratory reviews. 9(3), 181-191. [Abstract]
  • Aouad, L., Tam, K., Waters, K. (2008), Effects of acute intermittent hypercapnic hypoxia on insulin sensitivity in piglets using euglycemic clamp. Metabolism: clinical and experimental. 57(8), 1056-1063. [Abstract]
  • MacLean, J., Fitzsimons, D., Hayward, P., Waters, K., Fitzgerald, D. (2008), The identification of children with cleft palate and sleep disordered breathing using a referral system. Pediatric pulmonology. 43(3), 245-250. [Abstract]
  • Machaalani, R., Waters, K. (2008), Neuronal cell death in the Sudden Infant Death Syndrome brainstem and associations with risk factors. Brain. 131(Pt 1), 218-228. [Abstract]