A clinical study of paradoxical breathing during sleep in children / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Abnormal breathing during sleep included many patterns. In this study, we investigated paradoxical breathing patterns during sleep in children using standard polysomnography (PSG).</p><p><b>METHODS</b>Children who come to the ENT because of snoring were included into the study consecutively. Those who had craniofacial anomalies, diabetes, chronic lung diseases, and neuromuscular diseases were excluded. At the same time, no sleep snoring children were include as controls. Thirty-eight snoring children and twenty-six no snoring children were recruited. Polysomnography (PSG) was performed on all subjects. We determined the frequency of paradoxical breathing patterns during sleep through blind analysis of polysomnograms obtained in all subjects and compared the difference between children with snoring and normal controls.</p><p><b>RESULTS</b>The appearance of paradoxical breathing was assessed in all subjects. Among children with snoring, the apparent amount of paradoxical breathing time and the percent of paradoxical breathing time spent in total sleep time (x(-) ± s) were (70.1 ± 40.4) min and 17.9% ± 11.0% respectively. Comparing with control group (28.2 ± 25.7) min and 7.3% ± 6.8%, there was obvious difference (paradoxical breathing time t = 5.060, percent of paradoxical breathing time t = 4.767, P < 0.05). Thirty-eight snoring children were divided into normal-mild group (eighteen children) and moderate-severe group (twenty children). The children whose PSG results were normal and mild had more paradoxical breathing time and the percent of paradoxical breathing time than moderate-severe group. The apparent amount of paradoxical breathing time of normal-mild group, moderate-severe group and control group were (85.9 ± 31.7) min, (55.8 ± 42.7) min and (28.2 ± 25.7) min. Among the three groups, there was obvious difference (F = 15.897, P < 0.05). The percent of paradoxical breathing time of the three groups were 22.0% ± 10.2%, 14.1% ± 10.5% and 7.3% ± 6.8% (F = 14.167, P < 0.05).</p><p><b>CONCLUSIONS</b>Currently published polysomnographic scoring recommendations overlook some common breathing abnormalities during sleep that are associated with clinical complaints. Paradoxical breathing is abnormal breathing patterns during sleep and its appearance is used to aid in the identification of respiratory events.</p>

Analysis of poor-responding sleep apnea children to adenoidtonsillectomy and further treatment / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze factors on sleep apnea children's poor responding to adenoid tonsillectomy, and discuss the further treatment.</p><p><b>METHODS</b>Two hundred and forty three obstructive sleep apnea hypopnea syndrome (OSAHS) children who had adenoid tonsillectomy or adenoidectomy were reviewed, all cases had follow-up sleep study (polysomnogram, PSG) after surgery.</p><p><b>RESULTS</b>According to the results obtained in 3 to 12 months after surgery with PSG, 221 cases (90.9%) were cured (apnea and hypopnea index, AHI, < 5/h), while the remaining 22 cases AHI > 5.0/h. In the latter group, 2 cases who only had adenoidectomy received tonsillectomy afterwards, 7 cases who have nasal congestion were treated with medication, 5 overweight cases and 3 cases with cerebral palsy, pectus excavatum or hyperplastic tori were treated with CPAP.</p><p><b>CONCLUSIONS</b>Adenoid tonsillectomy is effective for OSAHS children. For the poor responding cases, suitable treatment should be selected accordingly.</p>