Cirugía del sueño: Definición de una especialidad emergente, propuesta de una clasificación anatomofuncional integral e indicaciones

Resumen Los trastornos respiratorios del sueño (ronquido primario y síndrome de apnea-hipopnea obstructiva del sueño) han sido tratados mediante múltiples modalidades a lo largo de la historia. Sin embargo, la cirugía de la vía aérea superior siempre ha estado presente, dando cabida a la aparición de múltiples técnicas para este fin. El estudio adecuado de los sitios anatómicos de estrechez o colapso de la vía aérea superior y sus contribuyentes (bajo el concepto de topodiagnóstico) y el mejor entendimiento de los mecanismos de acción de los diferentes procedimientos descritos, ha permitido el nacimiento de una nueva disciplina, dedicada al manejo quirúrgico planificado de este grupo de patologías: la cirugía del sueño.

Abstract Sleep-related breathing disorders (primary snoring and obstructive sleep apnea-hypopnea syndrome) have been treated with multiple modalities throughout history. However, upper airway surgery has always been present, giving appearance of multiple techniques for this purpose. The adequate study of the anatomical sites of upper airway narrowness or collapse and its contributors (under the concept of topodiagnosis) and a better understanding of the different procedures, has allowed the birth of a new discipline, dedicated to a planned surgical management for this group of pathologies: sleep surgery.

The association of sleep-related breathing disorders among pediatric patients with allergic rhinitis: A cross-sectional study in a university hospital

@#<p style="text-align: justify;"><strong>Introduction:</strong> Allergic rhinitis is a common condition in children linked to sleep-related breathing disorders (SRBD). Because of nasal congestion, it can cause obstructive sleep apnea, sleep fragmentation, and excessive fatigue. Studies regarding its association with SRBD is limited.</p><p style="text-align: justify;"><strong>Objectives:</strong> To determine the association of allergic rhinitis with sleep-related breathing disorders.</p><p style="text-align: justify;"><strong>Methodology:</strong> A cross-sectional analytical study involving pediatric patients diagnosed with allergic rhinitis was conducted. Allergic rhinitis severity was evaluated with the ARIA classification. SRBD was identified using the validated Filipino version of the pediatric sleep questionnaire. Potential association between allergic rhinitis and SRBD were assessed using the student's t-test, Fisher's exact test and odds ratio.</p><p style="text-align: justify;"><strong>Results:</strong> A total of 66 children with mean age 8.2 years were included in the study. The mean age, weight, height, and BMI were comparable among participants who were positive or negative for obstructive sleep apnea (OSA). Among the perceived problems related to sleeping disorders, snoring loudly, heavy breathing, dry mouth of awakening, not listening, and difficulty organizing showed different responses (p<0.05) among the subgroups of allergic rhinitis. The odds ratio of snoring loudly, not listening, difficulty organizing, heavy breathing, and unfreshened in the morning were more likely among patients with mild persistent allergic rhinitis compared to patients with mild intermittent allergic rhinitis.</p><p style="text-align: justify;"><strong>Conclusion:</strong> There was sufficient evidence to prove the association of SRBD with severity of allergic rhinitis using the validated Filipino version of the Pediatric Sleep Questionnaire. OSA shows a greater likelihood among patients with mild persistent allergic rhinitis compared to those with mild intermittent allergic rhinitis.</p>

Research status of sleep disorders in children / 中华实用儿科临床杂志

Good sleep plays a key role in children's physical growth,mental development and personality matu-rity.Sleep disorders are common and most easily neglected problems in children.Early sleep problems of children can sustain from childhood to adulthood,not only have relevance to the children's physical,cognitive and behavioral development,but also to be the high risk factors of the adult obesity,hypertension,depression,anxiety and other chronic diseases.A deep study of sleep disorders in children is very important for the protection of children's physical and men-tal health.This article reviews the etiology,classification,diagnosis and treatment of sleep disorders in children.

Case of a 19-Year-Old Male with Nocturnal Groaning (Catathrenia) / 수면정신생리

Catathrenia is a rare sleep disease characterized by monotonous groaning sounds that appear to be related with prolonged expiration, commonly experienced during rapid eye movement (REM) sleep. Catathrenia is also known as nocturnal groaning or sleep-related groaning and is currently categorized as a sleep-related breathing disorder. We present a rare case of a 19-year-old male with nocturnal groaning during non-REM sleep. We suggest that if catathrenia is suspected, polysomnography should be utilized to differentiate it from various sleep disorders such as snoring, central sleep apnea, sleep talking, parasomnia, and sleep-related movement disorders.

Menopause and Sleep Related Breathing Disorders / 대한폐경학회지

Women after the menopause appear to be more susceptible to sleep related breathing disorders (SBDs). The increased prevalence of SBDs in postmenopausal women may be related to weight gain and the decline in female sex hormones levels. These conditions may cause upper airway obstruction, which can result in sleep disruption. Other sleep disorders, such as insomnia, depression, and fibromyalgia must be ruled out with SBDs in postmenopausal women with sleep difficulties. Once SBD is strongly suspected through medical history and precise physical examinations, polysomnogram is required for confirmatory diagnosis. In addition, other examinations besides polysomnogram should be performed to detect obstructed regions. Treatment of SBD can be classified into surgical method and non-surgical method. Treatment options must be carefully selected by considering the patient's clinical examinations, patient's preference, age and life style.