Professor Karen Waters
People_

Professor Karen Waters

Professor
Discipline of Child and Adolescent Health, The Children's Hospital at Westmead
Phone
+61 2 9845 3437
Fax
+61 2 9845 3396
Professor Karen Waters

Professor Karen Waters (KW) is a conjoint professor of Child and Adolescent Health at the University of Sydney. She heads the Clinical service of Sleep Medicine at the Children’s Hospital at Westmead (CHW).

Karen is a senior researcher who provides oversight and coordination of a number of research projects at the CHW. She has an international reputation as a clinical researcher in Paediatric Sleep Medicine.

She was awarded her PhD in 1994, undertook a 3-year post-doctoral fellowship in Montreal Canada and continues to lead research teams in both clinical and basic science, relevant to sleep medicine in early development and childhood, with particular interest in Sudden Unexpected Death in Infancy (SUDI). She has been awarded NHMRC and NIH research funding, has over 150 publications in peer-reviewed journals with H-index 34.

Karen has supervised and mentored a number of research students and clinicians in areas of respiratory physiology, the neuropathology of sudden infant death syndrome (SIDS), and paediatric sleep medicine.

She is currently CIB on a multi-centre MRFF funded study, which focuses on improving sleep in children with neurodisability, which continues her collaboration with other sleep centres in Australia.

KW has a career-long participation in the Professional Societies for Sleep Medicine and Respiratory physicians (TSANZ – Thoracic Society of Australia and New Zealand) with experience on Professional credentialing committees, Conference Organising, development of guidelines pertinent to Paediatric Sleep and Respiratory Medicine, participation in accreditation of Sleep Units, and development of the item numbers used for billing Paediatric sleep medicine items in Australia. She regularly participates in peer-review activities, for Journals, conferences, and grants.

Karen is currently supervising 2 post-doctoral, 4 PhD, 2 Masters and 1 honours student. In the past she has supervised 3 post-doctoral, 9 PhD, 6 Masters, 13 honours, 16 Clinicians to successful completion.

There are three research themes for 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.

Please contact me, or members of my team if you have an interest in paediatric sleep medicine.

We are currently conducting clinical trials in:

- long term sequelae of mild OSA in children

- sleep disoders in children with Neurodisability

Sudden Infant Death Syndrome

Obesity, Diabetes and Cardiovascular Disease, Reproductive, Maternal and Child Health, Neurosciences and Mental Health

Publications

Book Chapters

  • Waters, K., Hunt, N., Machaalani, R. (2018). Neuropathology of Sudden Infant Death Syndrome: Hypothalamus. In Jhodie R. Duncan, Roger W. Byard (Eds.), Sudden infant and early childhood death: The past, the present and the future, (pp. 641-660). Adelaide: University of Adelaide Press. [More Information]
  • Machaalani, R., Hunt, N., Waters, K. (2016). Brain Orexin Receptors and Nicotine. In Victor R. Preedy (Eds.), Neuropathology of Drug Addictions and Substance Misuse - Volume 1: Foundations of Understanding, Tobacco, Alcohol, Cannabinoids and Opioids, (pp. 133-145). London: Academic Press. [More Information]
  • Caldwell, P., Waters, K. (2013). Nocturnal Enuresis. In Amy R. Wolfson, Hawley E. Montgomery-Downs (Eds.), Oxford Handbook of Infant, Child, and Adolescent Sleep and Behavior, (pp. 370-378). Oxford, United Kingdom: Oxford University Press. [More Information]

Journals

  • Von Huben, A., Deshpande, A., Scott, K., Caldwell, P., Howell, M., Richards, D., Hamilton, S., Howard, K., Teixeira-Pinto, A., Craig, J., Waters, K., et al (2024). An Economic Evaluation of a Web-Based Management Support System for Children with Urinary Incontinence: The eADVICE Trial. The Journal of Urology, 212(1), 185-195. [More Information]
  • Mehta, B., Waters, K., Fitzgerald, D., Badawi, N. (2024). Clinical characteristics, associated comorbidities and hospital outcomes of neonates with sleep disordered breathing: A retrospective cohort study. BMJ Paediatrics Open, 8(1), e002639. [More Information]
  • Luijerink, L., Waters, K., Rodriguez, M., Machaalani, R. (2024). GFAP expression in the BRAIN during human postnatal development. Neuropathology and Applied Neurobiology, 50(5), e13007. [More Information]

2024

  • Von Huben, A., Deshpande, A., Scott, K., Caldwell, P., Howell, M., Richards, D., Hamilton, S., Howard, K., Teixeira-Pinto, A., Craig, J., Waters, K., et al (2024). An Economic Evaluation of a Web-Based Management Support System for Children with Urinary Incontinence: The eADVICE Trial. The Journal of Urology, 212(1), 185-195. [More Information]
  • Mehta, B., Waters, K., Fitzgerald, D., Badawi, N. (2024). Clinical characteristics, associated comorbidities and hospital outcomes of neonates with sleep disordered breathing: A retrospective cohort study. BMJ Paediatrics Open, 8(1), e002639. [More Information]
  • Luijerink, L., Waters, K., Rodriguez, M., Machaalani, R. (2024). GFAP expression in the BRAIN during human postnatal development. Neuropathology and Applied Neurobiology, 50(5), e13007. [More Information]

2023

  • Chang, C., Vivekanandarajah, A., Waters, K., Machaalani, R. (2023). Cell death in the lateral geniculate nucleus, and its possible relationship with nicotinic receptors and sudden infant death syndrome (SIDS). Molecular Neurobiology. [More Information]
  • Al Deleemy, M., Huynh, B., Waters, K., Machaalani, R. (2023). Immunohistochemistry for acetylcholinesterase and butyrylcholinesterase in the dorsal motor nucleus of the vagus (DMNV) of formalin-fixed, paraffin-embedded tissue: comparison with reported literature. Histochemistry and Cell Biology, 159(3), 247-262. [More Information]
  • Kevat, A., Bernard, A., Harris, M., Heussler, H., Black, R., Cheng, A., Waters, K., Chawla, J. (2023). Impact of adenotonsillectomy on growth trajectories in preschool children with mild-moderate obstructive sleep apnea. The Journal of Clinical Sleep Medicine, 19(1), 55-62. [More Information]

2022

  • Harrington, C., Hafid, N., Waters, K. (2022). Butyrylcholinesterase is a potential biomarker for Sudden Infant Death Syndrome. EBioMedicine, 80, 104041. [More Information]
  • Singh, J., Zaballa, K., Kok, H., Fitzgerald, N., Uy, C., Nuth, D., Castro, C., Irving, C., Waters, K., Fitzgerald, D. (2022). Cheyne-stokes respiration in children with heart failure. Paediatric Respiratory Reviews, 43, 78-84. [More Information]
  • Lim, N., Wood, N., Prasad, A., Waters, K., Singh-Grewal, D., Dale, R., Elkadi, J., Scher, S., Kozlowska, K. (2022). COVID-19 Vaccination in Young People with Functional Neurological Disorder: A Case-Control Study. Vaccines, 10(12). [More Information]

2021

  • Jani, P., Lowe, K., Perdomo, A., Wakefield, L., Hinder, M., Galea, C., Goyen, T., Halliday, R., Waters, K., Badawi, N., Tracy, M. (2021). Cerebral Oxygenation and Perfusion When Positioning Preterm Infants: Clinical Implications. The Journal of Pediatrics, 235, 75-82.e1. [More Information]
  • Chawla, J., Harris, M., Black, R., Leclerc, M., Burns, H., Waters, K., Bernard, A., Lushington, K., Heussler, H. (2021). Cognitive parameters in children with mild obstructive sleep disordered breathing. Sleep and Breathing, 25(3), 1625-1634. [More Information]
  • Despotovski, V., Vivekanandarajah, A., Waters, K., Machaalani, R. (2021). Expression of reelin with age in the human hippocampal formation. Hippocampus, 31(5), 493-502. [More Information]

2020

  • Waters, K., Chawla, J., Harris, M., Heussler, H., Black, R., Cheng, A., Lushington, K. (2020). Cognition after early tonsillectomy for mild OSA. Pediatrics, 145(2), e20191450. [More Information]
  • Ambrose, N., Rodriguez, M., Waters, K., Machaalani, R. (2020). Microglia in the human infant brain and factors that affect expression. Brain, Behavior, & Immunity - Health, 7. [More Information]
  • AL-Iede, M., Al-Zayadneh, E., Bridge, C., Alqutawneh, B., Waters, K. (2020). Risk factors for postoperative pulmonary complications in children with severely compromised pulmonary function secondary to severe scoliosis. Pediatric Pulmonology, 55(10), 2782-2790. [More Information]

2019

  • Hirsch, D., Evans, C., Wong, M., Machaalani, R., Waters, K. (2019). Biochemical markers of cardiac dysfunction in children with obstructive sleep apnoea (OSA). Sleep and Breathing, 23(1), 95-101. [More Information]
  • Ambrose, N., Rodriguez, M., Waters, K., Machaalani, R. (2019). Cell death in the human infant central nervous system and in sudden infant death syndrome (SIDS). Apoptosis, 24(1-2), 46-61. [More Information]
  • Vivekanandarajah, A., Waters, K., Machaalani, R. (2019). Cigarette smoke exposure effects on the brainstem expression of nicotinic acetylcholine receptors (nAChRs), and on cardiac, respiratory and sleep physiologies. Respiratory Physiology and Neurobiology, 259, 1-15. [More Information]

2018

  • Ratnamohan, L., MacKinnon, L., Lim, M., Webster, R., Waters, K., Kozlowska, K., Silberg, J., Greenwald, R., Ribeiro, M. (2018). Ambushed by Memories of Trauma: Memory-Processing Interventions in an Adolescent Boy with Nocturnal Dissociative Episodes. Harvard Review of Psychiatry, 26(4), 228-236. [More Information]
  • AL-Iede, M., Kumaran, R., Waters, K. (2018). Home continuous positive airway pressure for cardiopulmonary indications in infants and children. Sleep Medicine, 48, 86-92. [More Information]
  • Castro-Codesal, M., DeHaan, K., Featherstone, R., Bedi, P., Carrasco, C., Katz, S., Chan, E., Bendiak, G., Almeida, F., Waters, K., Sullivan, C., et al (2018). Long-term non-invasive ventilation therapies in children: A scoping review. Sleep Medicine Reviews, 37, 148-158. [More Information]

2017

  • Okely, A., Ghersi, D., Hesketh, K., Santos, R., Loughran, S., Cliff, D., Shilton, T., Grant, D., Jones, R., Stanley, R., Waters, K., et al (2017). A collaborative approach to adopting/adapting guidelines - The Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): An integration of physical activity, sedentary behavior, and sleep. BMC Public Health, 17(Suppl 5), 167-190. [More Information]
  • Waters, K., Lowe, A., Cooper, P., Vella, S., Selvadurai, H. (2017). A cross-sectional analysis of daytime versus nocturnal polysomnographic respiratory parameters in cystic fibrosis during early adolescence. Journal of Cystic Fibrosis, 16(2), 250-257. [More Information]
  • Pamula, Y., Nixon, G., Edwards, E., Teng, A., Verginis, N., Davey, M., Waters, K., Suresh, S., Twiss, J., Tai, A. (2017). Australasian Sleep Association clinical practice guidelines for performing sleep studies in children. Sleep Medicine, 36(Suppl 1), S23-S42. [More Information]

2016

  • Machaalani, R., Hunt, N., Waters, K. (2016). Brain Orexin Receptors and Nicotine. In Victor R. Preedy (Eds.), Neuropathology of Drug Addictions and Substance Misuse - Volume 1: Foundations of Understanding, Tobacco, Alcohol, Cannabinoids and Opioids, (pp. 133-145). London: Academic Press. [More Information]
  • Hunt, N., Russell, B., Du, M., Waters, K., Machaalani, R. (2016). Changes in orexinergic immunoreactivity of the piglet hypothalamus and pons after exposure to chronic postnatal nicotine and intermittent hypercapnic hypoxia. European Journal of Neuroscience, 43(12), 1612-1622. [More Information]
  • Du, M., Hunt, N., Waters, K., Machaalani, R. (2016). Cumulative effects of repetitive intermittent hypercapnic hypoxia on orexin in the developing piglet hypothalamus. International Journal of Developmental Neuroscience, 48, 1-8. [More Information]

2015

  • Pandit, C., Waters, K., Jones, K., Young, H., Fitzgerald, D. (2015). Can daytime measures of lung function predict respiratory failure in children with neuromuscular disease? Paediatric Respiratory Reviews, 16(4), 241-245. [More Information]
  • Hunt, N., Rodriguez, M., Waters, K., Machaalani, R. (2015). Changes in orexin (hypocretin) neuronal expression with normal aging in the human hypothalamus. Neurobiology of Aging, 36(1), 292-300. [More Information]
  • Hunt, N., Waters, K., Rodriguez, M., Machaalani, R. (2015). Decreased orexin (hypocretin) immunoreactivity in the hypothalamus and pontine nuclei in sudden infant death syndrome. Acta Neuropathologica, 130(2), 185-198. [More Information]

2014

  • 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. [More Information]
  • Evans, C., Selvadurai, H., Baur, L., Waters, K. (2014). Effects of obstructive sleep apnea and obesity on exercise function in children. Sleep, 37(6), 1103-1110. [More Information]
  • Herbert, A., de Lima, J., Fitzgerald, D., Seton, C., Waters, K., Collins, J. (2014). Exploratory study of sleeping patterns in children admitted to hospital. Journal of Paediatrics and Child Health, 50(8), 632-638. [More Information]

2013

  • 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. [More Information]
  • 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. [More Information]
  • 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. [More Information]

2012

  • 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 Society for the Study of Inborn Errors of Metabolism (Eds.), JIMD Reports - Case and Research Reports, 2011/2, (pp. 103-106). Heidelberg: Springer. [More Information]
  • 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 and Neurobiology, 180(1), 25-33. [More Information]
  • 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. [More Information]

2011

  • 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. [More Information]
  • 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. [More Information]
  • 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, 568-571. [More Information]

2010

  • Trivedi, A., Waters, K., Suresh, S., Nair, R. (2010). Congenital central hypoventilation syndrome: Four families. Sleep and Breathing, 15(4), 785-789. [More Information]
  • Machaalani, R., Katebi 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), 223-231. [More Information]
  • 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), 655-661. [More Information]

2009

  • Waters, K., Cheng, A. (2009). Adenotonsillectomy in the context of obstructive sleep apnoea. Paediatric Respiratory Reviews, 10(1), 25-31. [More Information]
  • Hayward, P., Fitzgerald, D., Waters, K. (2009). Cleft lip and/or palate and breathing during sleep. Sleep Medicine Reviews, 13(5), 345-54. [More Information]
  • 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), 2215-2225. [More Information]

2008

  • Robinson, P., Waters, K. (2008). Are children just small adults? The differences between paediatric and adult sleep medicine. Internal Medicine Journal, 38(9), 719-731. [More Information]
  • 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, 195-205. [More Information]
  • 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. [More Information]

2007

  • Machaalani, R., Arlotto, M., Waters, K., Gozal, E., Berger, F., Dematteis, M. (2007). A Novel Method of Tissue Collection and Storage: Validation Using SELDI-TOF MS Analysis. Clinical Chemistry. [More Information]
  • Machaalani, R., Rodriguez, M., Waters, K. (2007). Active caspase-3 in the sudden infant death syndrome (SIDS) brainstem. Acta Neuropathologica, 113(5), 577-584. [More Information]
  • Say, M., Machaalani, R., Waters, K. (2007). Changes in serotoninergic receptors 1A and 2A in the piglet brainstem after intermittent hypercapnic hypoxia (IHH) and nicotine. Brain Research, 1152, 17-26. [More Information]

2006

  • Waters, K., Sithamparanathan, S., O'Brien, L., Bibby, S., de Torres, C., Vella, S., de la Eva, R. (2006). Follow-up on Metabolic Markers in Children Treated for Obstructive Sleep Aopnea. American Journal of Respiratory and Critical Care Medicine, 174(4), 455-460. [More Information]
  • Tam, C., Wong, M., McBain, R., Bailey, S., Waters, K. (2006). Inflammatory measures in children with obstructive sleep apnoea. Journal of Paediatrics and Child Health, 42(5), 277-282. [More Information]
  • Fanous, A., Machaalani, R., Waters, K. (2006). N-methyl-d-aspartate receptor 1 changes in the piglet brainstem after nicotine and/or intermittent hypercapnic-hypoxia. Neuroscience, 142(2), 401-409. [More Information]

2005

  • Kennedy, J., Waters, K. (2005). 8. Investigation and treatment of upper-airway obstruction: childhood sleep disorders I. Medical Journal of Australia, 182(8), 419-23. [More Information]
  • Machaalani, R., Waters, K., Tinworth, K. (2005). Effects of postnatal nicotine exposure on apoptotic markers in the developing piglet brain. Neuroscience, 132(2), 325-333. [More Information]
  • Waters, K., Tinworth, K. (2005). Habituation of arousal responses after intermittent hypercapnic hypoxia in piglets. American Journal of Respiratory and Critical Care Medicine, 171(11), 1305-11. [More Information]

2004

  • Peiris, T., Machaalani, R., Waters, K. (2004). Brain-Derived Neurotrophic Factor Mrna And Protein In The Piglet Brainstem And Effects Of Intermittent Hypercapnic Hypoxia. Brain Research, 1029 (1), 11-23. [More Information]
  • Waters, K. (2004). Cytokines In Sudden Infant Death Syndrome. The Lancet Neurology, 3(2), 81-81. [More Information]
  • Waters, K., Gozal, D. (2004). Developmental And Metabolic Implications Of The Hypoxic Ventilatory Response. Paediatric Respiratory Reviews, 5(3), 173-181. [More Information]

2003

  • Machaalani, R., Waters, K. (2003). Correlations between brainstem NMDA receptor changes and active neuronal cell death after intermittent hypercapnic hypoxia in the developing piglet. Brain Research, 975(1-2), 141-148. [More Information]
  • Waters, K., Tinworth, K. (2003). Effect of stimulus cycle time on acute respiratory responses to intermittent hypercapnic hypoxia in unsedated piglets. Journal of Applied Physiology, 94(6), 2465-2474. [More Information]
  • Machaalani, R., Waters, K. (2003). Increased neuronal cell death after intermittent hypercapnic hypoxia in the developing piglet brainstem. Brain Research, 985(2), 127-134. [More Information]

2002

  • Machaalani, R., Waters, K. (2002). Distribution and quantification of NMDA R1 and mRNA and protein in the piglet brainstem and effects of intermittent hypercapnic hopoxia (IHH). Brain Research, 951(2), 293-300. [More Information]
  • Waters, K., McBrien, F., Stewart, P., Hinder, M., Wharton, S. (2002). Effects of OSA, inhalational anesthesia, and fentanyl on the airway and ventilation of children. Journal of Applied Physiology, 92(5), 1987-1994. [More Information]
  • Baur, L., Waters, K., de, L., Donaghue, K. (2002). Metabolic correlates with obstructive sleep apnea in obese subjects. The Journal of Pediatrics, 140(6), 654-659. [More Information]

2001

  • Waters, K., Tinworth, K. (2001). Depression of ventilatory responses after daily, cyclic hypercapnic hypoxia in piglets. Journal of Applied Physiology, 90, 1065-1073.

Selected Grants

2024

  • Clinical utility of Level 3 sleep study in paediatric sleep medicine, Waters K, Department of Health and Aged Care (Federal - administered by NHMRC)/MRFF - Optimising Screening, Diagnosis and Management of Obstructive Sleep Apnoea

2012

  • Does Adenotonsillectomy Improve Neurocognition in pre-school children with Obstructive Sleep Apnoea (OSA), Waters K, Lushington K, Heussler H, National Health and Medical Research Council (NHMRC)/Project Grants