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DISTURBIOS RESPIRATORIOS DO SONO NA CRIANÇA

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Atualização no diagnóstico e tratamento da apnéia obstrutiva do sono na criança
balbani9.jpg Autor:
Aracy Pereira silveira balbani
Columnista Experto de SIIC

Institución:
Faculdade de Medicina de Botucatu (UNESP)

Artículos publicados por Aracy Pereira silveira balbani
Aprobación
7 de Septiembre, 2006 		Primera edición
6 de Septiembre, 2007 		Segunda edición, ampliada y corregida
7 de Junio, 2021

DISTURBIOS RESPIRATORIOS DO SONO NA CRIANÇA

Resumen
Crianças podem apresentar vários distúrbios respiratórios durante o sono: ronco primário, apnéia, hipopnéia e síndrome da resistência das vias aéreas superiores. A prevalência de distúrbios respiratórios do sono em crianças é de 0.7%-9%, com pico de incidência nos pré-escolares. Fatores anatômicos (obstrução nasal severa, más-formações craniofaciais, hipertrofia do tecido linfático da faringe, anomalias laríngeas, etc.) e funcionais (doenças neuromusculares) predispõem à síndrome da apnéia obstrutiva do sono (SAOS) na infância. A principal causa da SAOS em crianças é a hipertrofia adenotonsilar. As manifestações clínicas mais comuns são: ronco noturno, pausas respiratórias, sono agitado e respiração bucal. A oximetria de pulso noturna e a polissonografia breve diurna são métodos úteis para triagem dos casos suspeitos de SAOS em crianças, e o padrão-ouro para diagnóstico é a polissonografia em laboratório de sono durante uma noite inteira. Ao contrário dos adultos com SAOS, as crianças costumam apresentar: menos despertares associados aos eventos de apnéia, maior número de apnéias/hipopnéias durante o sono REM e dessaturação mais acentuada da oxihemoglobina mesmo nas apnéias de curta duração. O tratamento da SAOS pode ser cirúrgico (adenotonsilectomia, correção de anomalias craniofaciais, traqueostomia) ou clínico (higiene do sono, pressão positiva contínua nas vias aéreas - CPAP).

Palabras clave
Criança, apnéia do sono tipo obstrutiva, ronco, educação médica


Artículo completo
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SLEEP-DISORDERED BREATHING IN THE CHILD

Abstract
Children may suffer several breathing disorders during sleep: primary snoring, apnea, hypopnea and upper airway resistance syndrome. The prevalence of sleep disordered breathing in children is 0.7-9%, with peak incidence in pre-schoolers. It is characterised by partial or complete upper airway obstruction during sleep, causing intermittent hypoxia. Both anatomical (severe nasal obstruction, craniofacial anomalies, hypertrophy of the pharyngeal lymphoid tissue, laryngeal anomalies, etc.) and functional factors (neuromuscular diseases) predispose to obstructive sleep apnea syndrome (OSAS) during childhood. The main cause of OSAS in children is adenotonsillar hypertrophy. The most common clinical manifestations of OSAS are: nocturnal snoring, respiratory pauses, restless sleep and mouth breathing. Nocturnal pulse oximetry and nap polysomnography are useful tools for screening suspected cases of OSAS in children, and the gold-standard for diagnosis is overnight polysomnography in the sleep laboratory. On the contrary of SAOS adults, children usually present: less arousals associated to apnea events, more numerous apneas/hypopneas during REM sleep, and more significant oxihemoglobin dessaturation even in short apneas. The treatment of OSAS may be surgical (adenotonsillectomy, craniofacial abnormalities correction, tracheostomy) or clinical (sleep hygiene, continuous positive airway pressure - CPAP).

Key words
Child, obstructive sleep apnea, snoring, medical education

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Pediatría
Relacionadas: Atención Primaria, Medicina Familiar, Neumonología, Neurología, Otorrinolaringología



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Enviar correspondencia a:
Aracy Pereira Silveira Balbani, Disciplina de Otorrinolaringologia e Cirugia de Cabeça e Pescoço, Faculdade de Medicina de Botucatu (UNESP), 18270-070, Rua Capitão Lisboa, 715, cj. 33, Tatuí, Brasil
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