ABSTRACT
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
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 5 was 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, Sat.O2 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
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/therapy , Tonsillectomy/methods , Polysomnography , Retrospective Studies , Observational StudyABSTRACT
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 5 was 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, Sat.O2 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.
Subject(s)
Sleep Apnea, Obstructive , Child , Child, Preschool , Female , Humans , Male , Polysomnography , Retrospective Studies , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/therapyABSTRACT
En Castilla-La Mancha la población extranjera se ha multiplicado en el último quinquenio. La progresión de la incorporación de inmigrantes ha sido muy rápida en los últimos años, con incremento más acusado a partir del año 2001. Los inmigrantes proceden a menudo de comunidades socioeconómicas deprimidas, siendo la población infantil la más vulnerable. Existe una alta probabilidad de que estos niños estén incorrectamente vacunados y, por lo tanto, expuestos a agentes infecciosos a los que la población autóctona es inmune. En estas situaciones, debemos realizar una valoración médica inicial y una adecuada supervisión del estado vacunal, para administrar las vacunas mediante pautas aceleradas y conseguir una actualización de su carnet de vacunación de acuerdo con el calendario de inmunizaciones de nuestra comunidad autónoma. Para elaborar este trabajo se han consultado guías de atención al inmigrante de varias comunidades autónomas de nuestro país, las recomendaciones americanas del comité de inmunizaciones y, sobretodo, se han tenido en cuenta las recomendaciones del Comité Asesor de Vacunas (CAV) de la Asociación Española de Pediatría (AEP) de 2008 (AU)
The immigrant population in Castilla-La Mancha, Spain has multiplied in the last five years. The incorporation of immigrants has progressed very rapidly in the last few years with the greatest increase being in 2001. The immigrants often come from depressed socio-economic communities and the child population is the most vulnerable. There is a high probability that these children have not been adequately vaccinated and, therefore, are exposed to infectious agents to which the indigenous population is immune. For these children, we should perform an initial medical assessment and a review of their vaccine status in order to administer vaccines in an accelerated regimen. Thus bringing their vaccination record card up to date with the immunization calendar in our autonomous community. In order to carry out this work we have consulted guidelines on immigrant care in several autonomous communities in Spain, the American recommendations of the immunization committee and, in particular, the 2008 recommendations of the Vaccine Assessment Committee (CAV) and the Spanish Paediatric Society (AEP) have been taken into account (AU)
