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Sleep Clinical Record application in Brazilian children and its comparison with Italian children
Camila de Castro Corrêa1, Silke Anna Theresa Weber1, Melania Evangelisti2
1Department of Ophtalmology, Otolaryngology and Head and Neck Surgery, Botucatu Medical School, State University Sao Paulo, UNESP, Botucatu, Sao Paulo, Brazil.
Insights
Brazilian children with sleep complaints had higher Sleep Clinical Record (SCR) scores than Italian children, indicating more severe sleep-disordered breathing. Factors like obesity and tonsillar hypertrophy influenced these scores in Brazilian children.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Clinical Phenotyping
Background:
- Sleep-disordered breathing (SDB) is a common condition in children, impacting growth and development.
- The Sleep Clinical Record (SCR) is a tool used to assess the severity and phenotype of SDB.
- Cross-cultural comparisons of SDB phenotypes are essential for understanding global health disparities.
Purpose of the Study:
- To apply the Sleep Clinical Record (SCR) to Brazilian children with sleep complaints.
- To compare SCR results between Brazilian and Italian children.
- To identify variables influencing the SDB phenotype in Brazilian children.
Main Methods:
- A sample of Brazilian and Italian children (4-11 years) with sleep complaints were selected and matched for age, gender, obesity, and apnea-hypopnea index.
- The Sleep Clinical Record (SCR) instrument was utilized for assessment.
- Full-night cardiorespiratory monitoring was performed.
Main Results:
- Brazilian children (n=51) exhibited higher SCR scores (10.21 ± 7.56) compared to Italian children (n=102, 8.95 ± 2.55) (p=0.002).
- Brazilian children frequently presented with oral breathing (55%), tonsillar hypertrophy (69%), and malocclusion (84%).
- In Brazil, SCR was influenced by obesity, daytime sleepiness, enuresis, nocturnal choking, headache, and limb movements; in Italy, only obesity influenced SCR.
Conclusions:
- Brazilian children with SDB demonstrate a more severe clinical phenotype, reflected by higher SCR scores, than their Italian counterparts.
- Obesity, tonsillar hypertrophy, altered palate position, and dental malocclusion are significant factors contributing to the SCR score in Brazilian children.
- Healthcare access disparities in Brazil may contribute to the observed differences in SDB presentation and severity.
Objective:
To apply the Sleep Clinical Record (SCR) to a sample of Brazilian children with sleep complaints, to compare the results with Italian children, and to identify variables that influence phenotype.
Methods:
Brazilian and Italian children, 4-11 years of age and matched for age, gender, obesity, and apnea-hypopnea index and who presented with complaints related to sleep, were selected. The instrument used was the SCR, and the procedure used was full-night cardiorespiratory monitoring.
Results:
The sample consisted of 51 Brazilian children and 102 Italian children. Brazilian children presented with oral breathing (55%), tonsillar hypertrophy (69%), Friedman palate position (88%), malocclusion (84%), and OSAS score (Brouilette questionnaire) (55%). The SCR among obese Brazilian children was higher as compared to that in nonobese subjects (obese, 10.84 vs nonobese, 9.13; p = 0.03). In the comparison between Brazilian and Italian children, the total Brazilian SCR was higher than the Italian SCR score (Brazilian SCR, 10.21 ± 7.56; Italian SCR, 8.95 ± 2.55; p = 0.002). The Italian SCR score was influenced by obesity, whereas the Brazilian SCR was influenced by others symptoms (daytime sleepiness, enuresis, nocturnal choking, headache, limb movements).
Conclusion:
Brazilian children with sleep-disordered breathing show a higher SCR score as compared to Italian children. Obesity and tonsillar hypertrophy, Friedman palate position alteration, and dental malocclusion further influenced the total SCR score among Brazilian children. This may be due to access difficulties in Brazil where children should have more assistance to obtain medical care.
