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Published on: September 16, 2019
[A clinical study of paradoxical breathing during sleep in children]
Juan Gao1, Ya-mei Zhang, Shi-lin Liu
1Department of Otorhinolaryngology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
Insights
Snoring children exhibit significantly more paradoxical breathing during sleep than non-snoring children. This abnormal breathing pattern, identified via polysomnography (PSG), is crucial for diagnosing respiratory events in pediatric patients.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Diagnostic Tools in Sleep Studies
Context:
- Abnormal breathing patterns during sleep are common in children.
- Snoring in children can be indicative of underlying respiratory issues.
- Standard polysomnography (PSG) is a key diagnostic tool for sleep disorders.
Purpose:
- To investigate the prevalence and characteristics of paradoxical breathing patterns during sleep in children.
- To compare the occurrence of paradoxical breathing in snoring children versus non-snoring controls.
- To assess the relationship between snoring severity and paradoxical breathing patterns.
Summary:
- This study utilized polysomnography (PSG) to analyze sleep breathing patterns in 38 snoring children and 26 non-snoring controls.
- Snoring children demonstrated significantly higher durations and percentages of paradoxical breathing compared to controls (P < 0.05).
- Within the snoring group, children with normal-mild findings had more paradoxical breathing than those with moderate-severe findings, indicating a potential correlation.
Impact:
- Highlights the clinical significance of paradoxical breathing as an indicator of sleep-disordered breathing in children.
- Suggests that current polysomnography scoring guidelines may overlook certain common breathing abnormalities.
- Emphasizes the utility of identifying paradoxical breathing for aiding in the diagnosis of pediatric respiratory events during sleep.
Objective:
Abnormal breathing during sleep included many patterns. In this study, we investigated paradoxical breathing patterns during sleep in children using standard polysomnography (PSG).
Methods:
Children who come to the ENT because of snoring were included into the study consecutively. Those who had craniofacial anomalies, diabetes, chronic lung diseases, and neuromuscular diseases were excluded. At the same time, no sleep snoring children were include as controls. Thirty-eight snoring children and twenty-six no snoring children were recruited. Polysomnography (PSG) was performed on all subjects. We determined the frequency of paradoxical breathing patterns during sleep through blind analysis of polysomnograms obtained in all subjects and compared the difference between children with snoring and normal controls.
Results:
The appearance of paradoxical breathing was assessed in all subjects. Among children with snoring, the apparent amount of paradoxical breathing time and the percent of paradoxical breathing time spent in total sleep time (x(-) ± s) were (70.1 ± 40.4) min and 17.9% ± 11.0% respectively. Comparing with control group (28.2 ± 25.7) min and 7.3% ± 6.8%, there was obvious difference (paradoxical breathing time t = 5.060, percent of paradoxical breathing time t = 4.767, P < 0.05). Thirty-eight snoring children were divided into normal-mild group (eighteen children) and moderate-severe group (twenty children). The children whose PSG results were normal and mild had more paradoxical breathing time and the percent of paradoxical breathing time than moderate-severe group. The apparent amount of paradoxical breathing time of normal-mild group, moderate-severe group and control group were (85.9 ± 31.7) min, (55.8 ± 42.7) min and (28.2 ± 25.7) min. Among the three groups, there was obvious difference (F = 15.897, P < 0.05). The percent of paradoxical breathing time of the three groups were 22.0% ± 10.2%, 14.1% ± 10.5% and 7.3% ± 6.8% (F = 14.167, P < 0.05).
Conclusions:
Currently published polysomnographic scoring recommendations overlook some common breathing abnormalities during sleep that are associated with clinical complaints. Paradoxical breathing is abnormal breathing patterns during sleep and its appearance is used to aid in the identification of respiratory events.
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