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Vol. 88. Num. 5.01 May 2018Pages 237-290
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Vol. 88. Num. 5.01 May 2018Pages 237-290
Original Article
DOI: 10.1016/j.anpede.2017.07.003
Obstructive sleep apnoea syndrome
Síndrome de apneas-hipopneas durante el sueño
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Sergio García Castilloa,
Corresponding author
, María del Perpetuo Socorro Hoyos Vázquezb, Ramón Coloma Navarroa, Javier Cruz Ruiza, Francisco Javier Callejas Gonzáleza, Raúl Godoy Mayorala, Pedro Juan Tárraga Lópezc, José Antonio Rodríguez Montesd
a Servicio de Neumología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
b Servicio de Pediatría, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
c Atención Primaria de la Gerencia de Atención Integrada de Albacete, Albacete, Spain
d Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Paz, Madrid, Spain
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Tables (2)
Table 1. Results of the analysis of the sleep variables under study.
Table 2. Differences between the 2 subgroups.
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Abstract
Introduction

Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area.

Patients and methods

Retrospective descriptive study of sleep tests conducted on children up to 14 years old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected.

Results

The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age was 5 years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, SatO2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children.

Conclusions

Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight.

Keywords:
Obstructive sleep apnoea syndrome
Child
Polysomnography
Tonsillectomy
Resumen
Introducción

El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio.

Pacientes y métodos

Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución.

Resultados

Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad.

Conclusiones

La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso.

Palabras clave:
Síndrome de apnea obstructiva del sueño
Niño
Polisomnografía
Amigdalectomía

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