Department of Otolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São, Paulo, Brazil.
Int Forum Allergy Rhinol. 2016 May;6(5):465-71. doi: 10.1002/alr.21689. Epub 2016 Feb 19.
Our goals were to assess whether allergic rhinitis (AR) is an aggravating factor that affects the severity of sleep apnea in children with tonsils/adenoid hypertrophy (T&A) and to compare polysomnographic data from children with and without AR.
This prospective study included 135 children (age range, 3 to 14 years) with sleep-disordered breathing (SDB) resulting from T&A. Children with lung, neurological, or craniofacial problems; septal deviations; previous pharyngeal surgeries; or orthodontic treatments were excluded. All children underwent a clinical evaluation, nasopharyngoscopy or lateral X-ray imaging, sleep study, and hypersensitivity skin-prick test.
The mean patient age was 6.44 ± 2.55 years (83 males). AR was present in 42.2% of the children; 40% presented with sleep apnea; and 17.04% had sleep apnea and AR. The percentage of time spent in the rapid eye movement (REM) sleep stage was lower among children with AR without sleep apnea (p = 0.028); however, the percentage of REM sleep was not significantly different among children with apnea (p = 0.2922). No difference in the apnea-hypopnea index (AHI) was observed between the children with (AHI = 2.79 events/hour) and without AR (3.75 events/hour, p = 0.4427). A multivariate analysis showed that nasal congestion was an important factor that can affect the duration of the REM sleep stage.
AR affects REM sleep in children with SDB without sleep apnea, and AR is not an aggravating factor regarding the severity of AHI.
我们的目的是评估变应性鼻炎(AR)是否为加重因素,影响伴有扁桃体/腺样体肥大(T&A)的儿童睡眠呼吸暂停的严重程度,并比较伴有和不伴有 AR 的儿童的多导睡眠图数据。
这项前瞻性研究纳入了 135 名患有 T&A 导致的睡眠呼吸障碍(SDB)的儿童(年龄 3 至 14 岁)。患有肺部、神经或颅面问题、鼻中隔偏曲、先前的咽手术或正畸治疗的儿童被排除在外。所有儿童均接受了临床评估、鼻咽镜或侧位 X 射线成像、睡眠研究和过敏皮肤点刺试验。
患者平均年龄为 6.44±2.55 岁(83 名男性)。42.2%的儿童存在 AR;40%的儿童表现为睡眠呼吸暂停;17.04%的儿童同时患有睡眠呼吸暂停和 AR。在无睡眠呼吸暂停的 AR 儿童中,快速眼动(REM)睡眠阶段的时间百分比较低(p=0.028);然而,在有呼吸暂停的儿童中,REM 睡眠的百分比无显著差异(p=0.2922)。患有 AR 的儿童的呼吸暂停低通气指数(AHI)与无 AR 的儿童无差异(AHI=2.79 次/小时和 3.75 次/小时,p=0.4427)。多变量分析表明,鼻塞是影响 REM 睡眠阶段持续时间的重要因素。
AR 影响无睡眠呼吸暂停的 SDB 儿童的 REM 睡眠,且 AR 不是 AHI 严重程度的加重因素。