Περίληψη:
Obstructive sleep-disordered breathing (SDB) can result in cardiovascular and neurocognitive morbidity as well as adversely affect behavior, growth, quality of life, and nocturnal continence. This article summarizes the latest evidence regarding the morbidity related to obstructive SDB, commenting on the impact of severity of obstruction, that is, the difference in effects seen of moderate to severe obstructive sleep apnea syndrome (OSAS) compared to those of mild OSAS or primary snoring. The impact of therapy is discussed, focusing on which children are likely to benefit from treatment interventions; namely those with moderate or severe OSAS irrespective of the presence of morbidity, children with mild OSAS with associated morbidity or predictors of SDB persistence such as obesity, and children with complex conditions accompanied by upper airway obstruction like craniosynostosis and Prader–Willi syndrome. The co-existing conditions which may improve when treatment for obstructive SDB is offered are reviewed, while the clinical parameters associated with spontaneous improvement or resolution of obstructive SDB are discussed. The intention being to enable clinicians to make informed decisions on who should be treated, when and why. Pediatr Pulmonol. 2017;52:399–412. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Συγγραφείς:
Tan, H.-L.
Alonso Alvarez, M.L.
Tsaoussoglou, M.
Weber, S.
Kaditis, A.G.
Λέξεις-κλειδιά:
academic achievement; achondroplasia; adenotonsillectomy; Arnold Chiari malformation; Article; asthma; attention deficit disorder; cerebral palsy; cognitive defect; craniofacial synostosis; daytime somnolence; disease association; disease severity; Down syndrome; growth retardation; human; mandibular advancement; metabolic syndrome X; morbidity; motor dysfunction; mucopolysaccharidosis; neuromuscular disease; nocturnal enuresis; obesity; otitis media; positive end expiratory pressure; Prader Willi syndrome; prediction; problem behavior; quality of life; sleep disordered breathing; snoring; therapy effect; upper respiratory tract obstruction; watchful waiting; wheezing; abnormal respiratory sound; adenoidectomy; Attention Deficit Disorder with Hyperactivity; blood pressure; child; Child Behavior Disorders; Cognitive Dysfunction; complication; fatigue; Growth Disorders; heart rate; heart stroke volume; nocturnal enuresis; pathophysiology; physiology; pressoreceptor reflex; severity of illness index; Sleep Apnea, Obstructive; snoring; tonsillectomy, Adenoidectomy; Asthma; Attention Deficit Disorder with Hyperactivity; Baroreflex; Blood Pressure; Child; Child Behavior Disorders; Cognitive Dysfunction; Fatigue; Growth Disorders; Heart Rate; Humans; Metabolic Syndrome X; Nocturnal Enuresis; Otitis Media; Quality of Life; Respiratory Sounds; Severity of Illness Index; Sleep Apnea, Obstructive; Snoring; Stroke Volume; Tonsillectomy
