Hyperactivity and attention deficit syndrome in obstructive sleep apnea syndrome: is there improvement with surgical management?

UNLABELLED: Neuropsychological disorders are frequently associated with obstructive ventilatory disorders (OVD). AIM: To analyze the incidence of neuropsychological disorders in Brazilian children with OVD, using a screening questionnaire and to compare the answers given before and after surgery. PATIENTS AND METHODS: We studied 30 children with clinical diagnosis of OVD. The children were divided into 3 groups: group I, children aged 4 to 7; group II, from 8 to 10; and group III, children over 11. The applied questionnaires were answered by the parents or tutors, and comprised 30 questions, 10 for each disorder: attention deficit, hyperactivity and impulsivity. The children were diagnosed with one of the disorders when presented 3 or more positive answers. The follow up interview occurred 6 months after adenotonsillectomy. RESULTS: There was a predominance of male gender (60.6%) over female gender (39.4%). Group II presented the highest number of significant changes, with reductions raging from 87.5% to 33.3% of patients with attention deficit, 75% to 50% of the hyperactive patients, and 50% to 33% of the impulsive patients. CONCLUSION: There was neuropsychological improvement after the surgery, which occurred mainly in the children from group II. More interaction among health professionals is necessary when diagnosing and following up similar cases.

Distúrbio de hiperatividade e déficit de atenção na síndrome de apnéia obstrutuiva do sono: há melhora com tratamento cirúrgico? / Hyperactivity and attention deficit syndrome in obstructive sleep apnea syndrome: is there improvement with surgical management?

Distúrbios neuropsicológicos são encontrados em até 30 por cento de crianças com Distúrbio Ventilatório Obstrutivo (DVO). OBJETIVO: Analisar a incidência de distúrbios neuropsicológicos em crianças brasileiras com diagnóstico de DVO, através de um questionário de screening, e comparar respostas antes e depois do tratamento cirúrgico. PACIENTES E MÉTODOS: Foram estudadas 30 crianças com diagnóstico clínico de DVO divididas em 3 grupos etários: grupo I com crianças de 4 a 7 anos, grupo II de 8 a 10 anos e grupo III com 11 anos ou mais. Os questionários foram respondidos pelos pais/responsáveis, contendo 30 questões divididas em bloco de 10 sobre déficit de atenção, hiperatividade e impulsividade. As crianças receberam o diagnóstico de um dos distúrbios quando apresentavam 3 ou mais questões positivas. A segunda entrevista ocorreu 6 meses após a adenotonsilectomia. RESULTADOS: Houve predomínio do sexo masculino (60,6 por cento) em relação ao sexo feminino (39,4 por cento). O grupo II foi o que apresentou mais significativas mudanças, com redução de 87,5 por cento a 33,3 por cento dos pacientes com déficit de atenção, 75 por cento a 50 por cento dos hiperativos e 50 por cento a 33 por cento dos impulsivos. CONCLUSÕES: Houve melhora neuropsicológica após a cirurgia, o que ocorreu principalmente no grupo de escolares (8 a 10 anos). Maior interação entre os profissionais de saúde é necessária no diagnóstico e acompanhamento dessas crianças.

Neuropsychological disorders are frequently associated with obstructive ventilatory disorders (OVD). AIM: To analyze the incidence of neuropsychological disorders in Brazilian children with OVD, using a screening questionnaire and to compare the answers given before and after surgery. PATIENTS AND METHODS: We studied 30 children with clinical diagnosis of OVD. The children were divided into 3 groups: group I, children aged 4 to 7; group II, from 8 to 10; and group III, children over 11. The applied questionnaires were answered by the parents or tutors, and comprised 30 questions, 10 for each disorder: attention deficit, hyperactivity and impulsivity. The children were diagnosed with one of the disorders when presented 3 or more positive answers. The follow up interview occurred 6 months after adenotonsillectomy. RESULTS: There was a predominance of male gender (60.6 percent) over female gender (39.4 percent). Group II presented the highest number of significant changes, with reductions raging from 87.5 percent to 33.3 percent of patients with attention deficit, 75 percent to 50 percent of the hyperactive patients, and 50 percent to 33 percent of the impulsive patients. CONCLUSION: There was neuropsychological improvement after the surgery, which occurred mainly in the children from group II. More interaction among health professionals is necessary when diagnosing and following up similar cases.