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[Therapeutic results of respiratory disturbance during sleep in children]
Masayoshi Kobayashi1, Hiroshi Sakaida, Atsushi Yuta
1Department of Otorhinolaryngology, Mie University School of Medicine, Tsu.
Insights
Surgical treatment effectively resolves sleep-disordered breathing in children, significantly improving symptoms like snoring and sleep apnea. Recurrence rates are low, indicating long-term benefits for pediatric patients.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Pediatric Pulmonology
Context:
- Sleep-disordered breathing (SDB) is common in children.
- Symptoms include snoring, sleep apnea, mouth breathing, and nasal obstruction.
- Adenoid hypertrophy and enlarged palatine tonsils are primary causes of SDB in children.
Purpose:
- To evaluate the effectiveness of surgical intervention for SDB in pediatric patients.
- To assess symptom resolution and recurrence rates following adenotomy and/or tonsillectomy.
- To analyze the correlation between clinical factors and SDB severity.
Summary:
- A retrospective analysis of 72 children with SDB treated between 1992-2001.
- 66 children underwent adenotomy and/or tonsillectomy, showing rapid symptom improvement.
- Post-operative apnea index (AI) and SpO2 improved significantly, with low long-term recurrence rates for sleep apnea.
Impact:
- Surgical treatment offers a safe and effective solution for pediatric SDB.
- Early intervention can lead to sustained improvement in respiratory and sleep quality.
- This study highlights the positive long-term outcomes of surgical management for SDB in children.
Abstract:
We retrospectively analyzed 72 children suffering from respiratory disturbance during sleep at Mie University Hospital for sleep study or surgical treatment from 1992 to 2001. Their clinical symptoms included snoring (100% of 72 inpatients), sleep apnea (60%), mouth breathing (44%), and nasal obstruction (30%). Forty-seven reported sleep apnea and 28 (60% of total) corresponded to criteria for the sleep apnea syndrome (apnea index: AI > or = 5.0). These symptoms were caused by adenoid vegetation and/or hypertrophy of the palatine tonsils. No significant correlation was seen among size of the adenoid, that of the palatine tonsil, body mass index, AI, and blood oxygen saturation (SpO2) during sleep. Surgical treatment with adenotomy and/or tonsillectomy was performed in 66 patients. After treatment, clinical symptoms diminished within a week, and AI and SpO2 during sleep improved significantly. Recurrence of snoring was observed 19, 23, and 21% of patients 1, 3, and 5 years after treatment. Sleep apnea recurred in only 1 patient 7 years after adenotomy. Seventy-five percent of children who had the clinical symptoms 1 month after treatment have shown the same symptoms continuously for a long time. In conclusion, surgical treatment for children's respiratory disturbance during sleep is effective and involves a low rate of symptom recurrence.
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