Aggiornamento monografico
I disturbi respiratori ostruttivi nel sonno
SLEEP-DISORDERED OBSTRUCTIVE BREATHING
AUGUSTA BATTISTINI, ROBERTA MARVASI
Clinica Pediatrica, Universitŕ di Parma
Dicembre 2005 - pagg. 645 -652
Abstract
Sleep-Disordered Breathing (SDB) includes several clinical and functional syndromes which
range from primary snoring to Obstructive Sleep Apnea Syndrome (OSAS). Initially polysomnography
(PSG) was considered to be the gold standard for the diagnosis of OSAS. It has
been found to be a low sensitivity test for milder functional alterations such as the Upper
Airway Resistance Syndrome (UARS). Thereafter, diagnosis based on clinical scoring has become
more important. Adenotonsillectomy is the first therapeutical approach of OSAS and
in selected cases can be replaced, at least temporarily, by adenoidectomy. In children with genetic
syndromes with craniofacial malformations continuous positive airway pressure (CPAP)
and even craniofacial surgery may be indicated.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Battistini A. Sonno e patologie respiratorie
del bambino. Medico e Bambino 1986;5:362-73.
2. Sondheimer JM. Gastroesophageal reflux and sleep. In: Loughlin GM, Dekker M (Eds). Sleep and breathing in children. A Developmental Approach. New York, 2000:397-402.
3. Battistini A. Apnea ostruttiva durante il sonno nel bambino. In: Ostruzioni Respiratorie in Etŕ Pediatrica. Poletto ed. 2002:147-72.
4. Guilleminault C, Li KK, Khramtsov A, Pelayo R, Martinez S. Sleep Disordered Breathing: Surgical Outcomes in Prepubertal Children. Laryngoscope 2004;114:132-7.
5. Gislason T, Benediktsdottir B. Snoring, apneic episodes, and nocturnal hypoxaemia among children 6 months to 6 years: an epidemiologic study of lower limit of prevalence. Chest 1995;107:963-6.
6. Guilleminault C. Does benign “Primary snoring” ever exist in children? Chest 2004;126: 1396-97.
7. Guilleminault C, Chowdhuri S. Upper airway resistance syndrome is a distinct syndrome. Am J Respir Crit Care Med 2000;161: 1412-6.
8. Douglas NJ. Upper airway resistance syndrome is not a distinct syndrome. Am J Respir Crit Care Med 2000;161:1413-5.
9. Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 1996;153:866-78.
10. Programma Nazionale Linee Guida 4: Documento d’indirizzo. Appropriatezza clinica e organizzativa degli interventi di tonsillectomia e/o adenoidectomia. Ministero della Salute, 2003.
11. Villa MP, Brunetti L, Bruni O, et al. Linee guida per la diagnosi della sindrome delle apnee ostruttive nel sonno in etŕ pediatrica. Minerva Pediatr 2004;56: 239-53.
12. Sulit LG, Storfer-Isser A, Rosen CL, et al. Associations of obesity, sleep-disordered breathing and wheezing in children. Am J Respir Crit Care Med 2005;171:659-64.
13. Gottlieb D, Chase C, Vezina RM, et al. Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5- year old children. J Pediatr 2004;145:458-64.
14. Archbold KH, Pituch KJ, Panahi P, Chervin RD. Symptoms of sleep disturbances among children at two general pediatric clinics. J Pediatr 2002;140: 97-102.
15. Battistini A, Ndaka JL, Banchini Pantano C, et al. Il Pediatra di Famiglia e i disturbi respiratori ostruttivi nel sonno. Ped Med Chir 2004;26:34-44.
16. Perletti L, Lispi L, et al. L’appropriatezza clinica ed organizzativa degli interventi di tonsillectomia e/o adenoidectomia. Ospedale & Territorio 2005;7:62-73.
17. Battistini A, Gerarduzzi T. Diagnosi e terapia del bambino con sindrome delle apnee del sonno (OSAS). Il punto su… Pagine elettroniche 2005: www.medicoebambino.com.
18. Urschitz MS, Guenther A, Eitner S, et al. Risk factors and natural history of habitual snoring. Chest 2004;126:790-800.
19. Franklin KA, Gislason T, Omenaas E, et al. The influence of active and passive smoking on habitual snoring. Am J Respir Crit Care Med 2004;170:799-803.
20. Battistini A. Dal respiro russante alla sindrome di apnea nel sonno. In: Argomenti di Malattie Respiratorie Infantili, Pisa, Pacini Editore, 1998:159-76.
21. Battistini A, Sansebastiano G, Zoni R, Pessina V, De’ Munari E. Asma e inquinamento intradomiciliare da processi di combustione (riscaldamento e gas per cucinare). Riv Ital Pediatr 2000;26:302-13.
22. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. J Allergy Clin Immunol 1997;99:s757-62.
23. Mitchell B. Sleep-disordered breathing in children: are we underestimating the problem? Eur Respir J 2005;25:216-217
24. Tarasiuk A, Tzahit S, Asher T, Haim R. Adenotonsillectomy in children with obstructive sleep apnea syndrome reduces health care utilization. Pediatrics 2004;113:351-56.
25. Guilleminault C, Pelayo R, Leger D, et al. Recognition of sleep-disordered breathing in children. Pediatrics, 1996;98: 871-82.
26. Villa MP, Pagani J, Miano S, Parisi P. Sindrome delle apnee ostruttive nel sonno in etŕ pediatrica. Area Pediatrica - Dossier Pneumologia 2005,6:I-XX.
27. Kelly A, Marcus C. Childhood obesity, inflammation, and apnea. Am J Respir Crit Care Med 2005;171:202-3.
28. Sivan Y, Kornecki A, Schonfeld T. Screening obstructive sleep apnoea syndrome by home videotape recording in children. Eur Respir J, 1996;9:2127-31.
29. Brouillette RT, Morielli A, Leimanis A, et al. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics 2000;105:405-12.
30. Marcus CL, Keens TG, Ward SL. Comparison of nap ad overnight polysomnography in children. Pediatr Pulmonol 1992;13:16-21.
31. Saeed MM, Keens TG, Stabile MW, et al. Should children with suspected obstructive sleep apnea syndrome and normal nap sleep studies have overnight sleep studies? Chest 2000;118:360-5.
32. Wang DY, Bernheim N, Kaufman L, Clement P. Assessment of adenoid size in children by fibreoptic examination. Clin Otolaryngol 1997;22:172-7.
33. American Academy of Pediatrics. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2002;109:704-12.
34. Loughlin GM. Obstructive sleep apnea syndrome in children. In: Loughlin GM, Dekker M (Eds). Sleep and Breathing in Children. A Developmental Approach. New York, 2000:625-50.
35. Chervin RD, Archbold KH, Dillon JE, et al. Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics 2002; 109:449-56.
36. Rosen CL, Storfer-Isser A, Taylor G, et al. Increased behavioral morbidity in schoolaged children with sleep-disordered breathing. Pediatrics 2004;114:1640-8.
37. Gozal D, Pope DW jr. Snoring during early childhood and academic performance at ages thirteen to fourteen years. Pediatrics 2001; 107:1394-9.
38. Nieminen P, Löppönen T, Tolonen U, et al. Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea. Pediatrics 2002;109:e55.
39. Amin RS, Kimball TR, Bean JA, et al. Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 2002;165:1395-99.
40. Corbo GM, Forastiere F, Agabiti N, et al. Snoring in 9 to 15 year-old children: risk factors and clinical relevance. Pediatrics 2001; 108:1149-54.
41. Goldstein NA, Pugazhendhi V, Rao SM, et al. Clinical assessment of pediatric obstructive sleep apnea. Pediatrics 2004;114:33-43.
42. Nixon GM, Kermack AS, Davis GM, et al. Planning adenotonsillectomy in children with Obstructive Sleep Apnea: the role of overnight oximetry. Pediatrics 2004;113:e19-25.
43. Owens JA. The practice of pediatric sleep medicine: results of a community survey. Pediatrics 2001;108:e51.
44. Lim J, McKean M. Adenotonsillectomy for obstructive sleep apnea in children. Cochrane Library, Issue 1, 2004.
45. Montgomery-Downs HE, Crabtree VM, et al. Cognition, sleep and respiration in at risk children treated for obstructive sleep apnea. Eur Respir J 2005;25:336-42.
46. Duncan P, Fain F. The case for an outpatient “approach” for all pediatric tonsillectomies and/or adenoidectomies: a 4-year review of 1419 cases at a community hospital. Otolaryngol Head Neck Surg 2002;127:101-8.
47. Shintani T, Asakura K, Kataura A. The effect of adenotonsillectomy in children with OSA. Int J Pediatr Otorhinolaryngol 1998; 44:51-8.
48. Kay DG, Mehta V. Perioperative adenotonsillectomy management in children: current practices. Laryngoscope 2003;113:592-7.
49. Brown KA, Morin I, Hickey C, et al. Urgent adenotonsillectomy. Anesthesiology 2003;99: 586-95.
50. Pearl AJ, Manoukian JJ. Adenoidectomy: indirect visualization of choanal adenoids. J Otolaryngol 1994;23:221-4.
51. Garyfallou GT, Costalas SK, Murphy CJ. Acute pulmonary edema in child with spasmodic croup. Am J Emerg Med 1997;15:211-3.
52. McLean HA, Urton AM, Driver HS, et al. Effect of treating severe nasal obstruction on the severity of obstructive sleep apnea. Eur Respir J 2005;25:521-7.
53. Brouillette RT, Manoukian JJ, Ducharme FM, et al. Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr 2001;138:838-44.
54. Arens R. It is time to consider a new treatment for children with sleep-disordered breathing. Am J Respir Crit Care Med 2005; 172:264-5.
2. Sondheimer JM. Gastroesophageal reflux and sleep. In: Loughlin GM, Dekker M (Eds). Sleep and breathing in children. A Developmental Approach. New York, 2000:397-402.
3. Battistini A. Apnea ostruttiva durante il sonno nel bambino. In: Ostruzioni Respiratorie in Etŕ Pediatrica. Poletto ed. 2002:147-72.
4. Guilleminault C, Li KK, Khramtsov A, Pelayo R, Martinez S. Sleep Disordered Breathing: Surgical Outcomes in Prepubertal Children. Laryngoscope 2004;114:132-7.
5. Gislason T, Benediktsdottir B. Snoring, apneic episodes, and nocturnal hypoxaemia among children 6 months to 6 years: an epidemiologic study of lower limit of prevalence. Chest 1995;107:963-6.
6. Guilleminault C. Does benign “Primary snoring” ever exist in children? Chest 2004;126: 1396-97.
7. Guilleminault C, Chowdhuri S. Upper airway resistance syndrome is a distinct syndrome. Am J Respir Crit Care Med 2000;161: 1412-6.
8. Douglas NJ. Upper airway resistance syndrome is not a distinct syndrome. Am J Respir Crit Care Med 2000;161:1413-5.
9. Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 1996;153:866-78.
10. Programma Nazionale Linee Guida 4: Documento d’indirizzo. Appropriatezza clinica e organizzativa degli interventi di tonsillectomia e/o adenoidectomia. Ministero della Salute, 2003.
11. Villa MP, Brunetti L, Bruni O, et al. Linee guida per la diagnosi della sindrome delle apnee ostruttive nel sonno in etŕ pediatrica. Minerva Pediatr 2004;56: 239-53.
12. Sulit LG, Storfer-Isser A, Rosen CL, et al. Associations of obesity, sleep-disordered breathing and wheezing in children. Am J Respir Crit Care Med 2005;171:659-64.
13. Gottlieb D, Chase C, Vezina RM, et al. Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5- year old children. J Pediatr 2004;145:458-64.
14. Archbold KH, Pituch KJ, Panahi P, Chervin RD. Symptoms of sleep disturbances among children at two general pediatric clinics. J Pediatr 2002;140: 97-102.
15. Battistini A, Ndaka JL, Banchini Pantano C, et al. Il Pediatra di Famiglia e i disturbi respiratori ostruttivi nel sonno. Ped Med Chir 2004;26:34-44.
16. Perletti L, Lispi L, et al. L’appropriatezza clinica ed organizzativa degli interventi di tonsillectomia e/o adenoidectomia. Ospedale & Territorio 2005;7:62-73.
17. Battistini A, Gerarduzzi T. Diagnosi e terapia del bambino con sindrome delle apnee del sonno (OSAS). Il punto su… Pagine elettroniche 2005: www.medicoebambino.com.
18. Urschitz MS, Guenther A, Eitner S, et al. Risk factors and natural history of habitual snoring. Chest 2004;126:790-800.
19. Franklin KA, Gislason T, Omenaas E, et al. The influence of active and passive smoking on habitual snoring. Am J Respir Crit Care Med 2004;170:799-803.
20. Battistini A. Dal respiro russante alla sindrome di apnea nel sonno. In: Argomenti di Malattie Respiratorie Infantili, Pisa, Pacini Editore, 1998:159-76.
21. Battistini A, Sansebastiano G, Zoni R, Pessina V, De’ Munari E. Asma e inquinamento intradomiciliare da processi di combustione (riscaldamento e gas per cucinare). Riv Ital Pediatr 2000;26:302-13.
22. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. J Allergy Clin Immunol 1997;99:s757-62.
23. Mitchell B. Sleep-disordered breathing in children: are we underestimating the problem? Eur Respir J 2005;25:216-217
24. Tarasiuk A, Tzahit S, Asher T, Haim R. Adenotonsillectomy in children with obstructive sleep apnea syndrome reduces health care utilization. Pediatrics 2004;113:351-56.
25. Guilleminault C, Pelayo R, Leger D, et al. Recognition of sleep-disordered breathing in children. Pediatrics, 1996;98: 871-82.
26. Villa MP, Pagani J, Miano S, Parisi P. Sindrome delle apnee ostruttive nel sonno in etŕ pediatrica. Area Pediatrica - Dossier Pneumologia 2005,6:I-XX.
27. Kelly A, Marcus C. Childhood obesity, inflammation, and apnea. Am J Respir Crit Care Med 2005;171:202-3.
28. Sivan Y, Kornecki A, Schonfeld T. Screening obstructive sleep apnoea syndrome by home videotape recording in children. Eur Respir J, 1996;9:2127-31.
29. Brouillette RT, Morielli A, Leimanis A, et al. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics 2000;105:405-12.
30. Marcus CL, Keens TG, Ward SL. Comparison of nap ad overnight polysomnography in children. Pediatr Pulmonol 1992;13:16-21.
31. Saeed MM, Keens TG, Stabile MW, et al. Should children with suspected obstructive sleep apnea syndrome and normal nap sleep studies have overnight sleep studies? Chest 2000;118:360-5.
32. Wang DY, Bernheim N, Kaufman L, Clement P. Assessment of adenoid size in children by fibreoptic examination. Clin Otolaryngol 1997;22:172-7.
33. American Academy of Pediatrics. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2002;109:704-12.
34. Loughlin GM. Obstructive sleep apnea syndrome in children. In: Loughlin GM, Dekker M (Eds). Sleep and Breathing in Children. A Developmental Approach. New York, 2000:625-50.
35. Chervin RD, Archbold KH, Dillon JE, et al. Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics 2002; 109:449-56.
36. Rosen CL, Storfer-Isser A, Taylor G, et al. Increased behavioral morbidity in schoolaged children with sleep-disordered breathing. Pediatrics 2004;114:1640-8.
37. Gozal D, Pope DW jr. Snoring during early childhood and academic performance at ages thirteen to fourteen years. Pediatrics 2001; 107:1394-9.
38. Nieminen P, Löppönen T, Tolonen U, et al. Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea. Pediatrics 2002;109:e55.
39. Amin RS, Kimball TR, Bean JA, et al. Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 2002;165:1395-99.
40. Corbo GM, Forastiere F, Agabiti N, et al. Snoring in 9 to 15 year-old children: risk factors and clinical relevance. Pediatrics 2001; 108:1149-54.
41. Goldstein NA, Pugazhendhi V, Rao SM, et al. Clinical assessment of pediatric obstructive sleep apnea. Pediatrics 2004;114:33-43.
42. Nixon GM, Kermack AS, Davis GM, et al. Planning adenotonsillectomy in children with Obstructive Sleep Apnea: the role of overnight oximetry. Pediatrics 2004;113:e19-25.
43. Owens JA. The practice of pediatric sleep medicine: results of a community survey. Pediatrics 2001;108:e51.
44. Lim J, McKean M. Adenotonsillectomy for obstructive sleep apnea in children. Cochrane Library, Issue 1, 2004.
45. Montgomery-Downs HE, Crabtree VM, et al. Cognition, sleep and respiration in at risk children treated for obstructive sleep apnea. Eur Respir J 2005;25:336-42.
46. Duncan P, Fain F. The case for an outpatient “approach” for all pediatric tonsillectomies and/or adenoidectomies: a 4-year review of 1419 cases at a community hospital. Otolaryngol Head Neck Surg 2002;127:101-8.
47. Shintani T, Asakura K, Kataura A. The effect of adenotonsillectomy in children with OSA. Int J Pediatr Otorhinolaryngol 1998; 44:51-8.
48. Kay DG, Mehta V. Perioperative adenotonsillectomy management in children: current practices. Laryngoscope 2003;113:592-7.
49. Brown KA, Morin I, Hickey C, et al. Urgent adenotonsillectomy. Anesthesiology 2003;99: 586-95.
50. Pearl AJ, Manoukian JJ. Adenoidectomy: indirect visualization of choanal adenoids. J Otolaryngol 1994;23:221-4.
51. Garyfallou GT, Costalas SK, Murphy CJ. Acute pulmonary edema in child with spasmodic croup. Am J Emerg Med 1997;15:211-3.
52. McLean HA, Urton AM, Driver HS, et al. Effect of treating severe nasal obstruction on the severity of obstructive sleep apnea. Eur Respir J 2005;25:521-7.
53. Brouillette RT, Manoukian JJ, Ducharme FM, et al. Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr 2001;138:838-44.
54. Arens R. It is time to consider a new treatment for children with sleep-disordered breathing. Am J Respir Crit Care Med 2005; 172:264-5.