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Children and nocturnal snoring: evaluation of the effects of sleep related respiratory resistive load and daytime

C Guilleminault, R Winkle, R Korobkin

    European Journal of Pediatrics
    |November 1, 1982
    PubMed

    Insights

    Pediatric respiratory resistive load during sleep, not sleep apnea, caused symptoms like excessive daytime sleepiness. Surgery to remove tonsils and adenoids resolved these breathing and sleep issues in children.

    Area of Science:

    • Pediatric Sleep Medicine
    • Otolaryngology
    • Respiratory Physiology

    Background:

    • Children referred to sleep clinics often present with symptoms like excessive daytime somnolence, heavy snoring, and behavioral issues.
    • These symptoms can be indicative of underlying respiratory disturbances during sleep.

    Purpose of the Study:

    • To investigate the cause of respiratory resistive load during sleep in children presenting with specific clinical symptoms.
    • To evaluate the efficacy of tonsillectomy and/or adenoidectomy in resolving these symptoms and improving sleep quality.

    Main Methods:

    • Polygraphic sleep monitoring was conducted on 25 children (ages 2-14).
    • Respiratory parameters, including electrocardiographic R-R intervals and endoesophageal pressure, were analyzed.
    • Objective sleep evaluations using the Multiple Sleep Latency Test and Wilkinson Addition Test were performed post-surgery.

    Main Results:

    • No cases of sleep apnea syndrome or oxygen desaturation were identified.
    • Children exhibited significant respiratory resistive load during sleep, most pronounced during REM sleep.
    • Tonsillectomy and/or adenoidectomy led to complete resolution or significant improvement in reported symptoms.

    Conclusions:

    • Respiratory resistive load during sleep, rather than sleep apnea, is a key factor in certain pediatric sleep disorders.
    • Surgical intervention (tonsillectomy/adenoidectomy) is an effective treatment for improving sleep-related respiratory issues and associated symptoms in children.

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