Síndrome da apneia e hipopneia obstrutiva do sono em crianças e adolescentes com síndrome de Down: estudo clínico
Carregando...
Data
2022-07-27
Autores
Favaro, Lorena Luana Batista
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Objetivos: Avaliar a prevalência da síndrome de apneia e hipopneia obstrutiva do sono (SAOS) em crianças e adolescentes com síndrome de Down (SD) seguidas ambulatorialmente em um hospital terciário e identificar quais fatores estão relacionados à doença e sua gravidade. Método: O total de 35 pacientes com SD foram inseridos neste estudo transversal após convocação para realizar polissonografia e aplicação de questionários estruturados e padronizados, entre março de 2021 e junho de 2022, com descrição dos dados por média ± desvio padrão para variáveis contínuas e frequência e porcentagem nas categóricas, sendo considerado significativo p ≤ 0,05. Resultados: A amostra selecionada é constituída de 57,1% meninas, com as médias de idade, peso e índice de massa corpórea z-escore, respectivamente, 87,5 meses (± 45,5), 29,0 quilogramas (± 16,2) e 0,6 (± 1,3). A SAOS foi diagnosticada em 96,3% dos casos, com um índice de apneia e hipopneia médio de 11,3 eventos por hora (± 12,5) e doença moderada ou grave em mais da metade da população (59,2%). A gravidade da condição apresentou associação significativa com relato de ronco pelos pais (p 0,045) e quando referido > 3 vezes por semana (p 0,02), assim como com peso (p 0,02), presença de comorbidades (p 0,003) e sonolência excessiva diurna segundo a escala de Epworth modificada (p 0,001). Considerações: Os resultados evidenciam a elevada prevalência de SAOS nesta população e a associação entre relato de ronco, peso, presença de comorbidades e sonolência diurna com a gravidade da doença, o que demonstra a aplicabilidade de ferramentas para triagem e reforça a importância do diagnóstico para a melhoria no acompanhamento desses pacientes.
Objectives: To assess the prevalence of obstructive sleep apnea and hypopnea syndrome (OSAS) in children and adolescents with Down syndrome (DS) followed up at an outpatient clinic in a tertiary hospital and to identify which factors are related to the disease and its severity. Method: A total of 35 patients with DS were included in this cross-sectional study after being invited to undergo polysomnography and application of structured and standardized questionnaires, between March 2021 and June 2022, with data description by mean ± standard deviation for continuous variables and frequency and percentage in the categorical ones, with p ≤ 0.05 being considered significant. Results: The selected sample consists of 57.1% girls, with mean age, weight and body mass index z-score, respectively, 87.5 months (± 45.5), 29.0 kilograms (± 16.2) and 0.6 (± 1.3). OSAS was diagnosed in 96.3% of cases, with a mean apnea-hypopnea index of 11.3 events per hour (± 12.5) and moderate or severe disease in more than half of the population (59.2%). The severity of the condition was significantly associated with reports of snoring by parents (p 0.045) and when reported > 3 times a week (p 0.02), as well as with weight (p 0.02), presence of comorbidities (p 0.003) and excessive daytime sleepiness according to the modified Epworth scale (p 0.001). Considerations: The results show the high prevalence of OSAS in this population and the association between reports of snoring, weight, presence of comorbidities and daytime sleepiness with the severity of the disease, which demonstrates the applicability of screening tools and reinforces the importance of diagnosis for improvement in the follow-up of these patients.
Objectives: To assess the prevalence of obstructive sleep apnea and hypopnea syndrome (OSAS) in children and adolescents with Down syndrome (DS) followed up at an outpatient clinic in a tertiary hospital and to identify which factors are related to the disease and its severity. Method: A total of 35 patients with DS were included in this cross-sectional study after being invited to undergo polysomnography and application of structured and standardized questionnaires, between March 2021 and June 2022, with data description by mean ± standard deviation for continuous variables and frequency and percentage in the categorical ones, with p ≤ 0.05 being considered significant. Results: The selected sample consists of 57.1% girls, with mean age, weight and body mass index z-score, respectively, 87.5 months (± 45.5), 29.0 kilograms (± 16.2) and 0.6 (± 1.3). OSAS was diagnosed in 96.3% of cases, with a mean apnea-hypopnea index of 11.3 events per hour (± 12.5) and moderate or severe disease in more than half of the population (59.2%). The severity of the condition was significantly associated with reports of snoring by parents (p 0.045) and when reported > 3 times a week (p 0.02), as well as with weight (p 0.02), presence of comorbidities (p 0.003) and excessive daytime sleepiness according to the modified Epworth scale (p 0.001). Considerations: The results show the high prevalence of OSAS in this population and the association between reports of snoring, weight, presence of comorbidities and daytime sleepiness with the severity of the disease, which demonstrates the applicability of screening tools and reinforces the importance of diagnosis for improvement in the follow-up of these patients.
Descrição
Palavras-chave
Síndrome de Down, Distúrbios do sono, Síndrome da apneia obstrutiva do sono, Pediatria, Down syndrome, Sleep disorders, Obstructive sleep apnea syndrome, Pediatrics