폐쇄성 수면무호흡증후군 소아에서 삶의 질과수면다원검사 지수와의 상관관계

Correlation between Quality of Life and Indices of Polysomnography in Children withObstructive Sleep Apnea Syndrome

임현우;이상학;이흥만;최지호;권순영;신철;이승훈

  • 발행 : 20060000

초록

Sleep disordered breathing (SDB) can have an effect on the quality of life in children by causing sleep disturbance, physical symptoms, emotional distress and daytime function. We aim to verify the correlation between the sleep related quality of life and indices of full nocturnal polysomnography in children with obstructive sleep apnea syndrome. Subjects and Method:Twenty-three children aged from 3 through 15 years old (male:16, female:7) diagnosed to have obstructive sleep apnea syndrome using the full nocturnal polysomnography were studied. The caregivers for each child were asked to complete a KOSA-18 (Korean Obstructive Sleep Apnea-18) survey to define the sleep related quality of life. The relationship between indices of polysomnography and the total score of KOSA-18 (KOSA-18 T score) were analyzed by Spearman correlation. Results:There was significant correlation between KOSA-18 T score and respiratory disturbance index (RDI) (R=0.556, p=.006), KOSA-18 T score and arousal index (R=0.466, p=.025), and KOSA-18 T score and snoring (R=0.472, p=.027). However, the others did not show significant correlation. Conclusion:The 70% in children with obstructive sleep apnea syndrome has higher degree of impairment in the sleep related quality of life. The larger the impairment in the children’s quality of life by obstructive sleep apnea is, the higher the score of RDI, arousal index and snoring are. Therefore, earlier and more aggressive management may be needed in children with high KOSA-18.

키워드

참고문헌

  1. Gislason T, Benediktsdottir B. Snoring, apneic episodes. and nocturnal hypoxemia among children 6 months to 6 years old. An epidemiologic study of lower limit of prevalence. Chest 1995;107:963-6 https://doi.org/10.1378/chest.107.4.963
  2. de Serres LM, Derkay C, Sie K, Biavati M, Jones J, Tunkel D. et al. Impact of adenotonsillectomy Oil quality of life ill children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg 2002;128:489-96 https://doi.org/10.1001/archotol.128.5.489
  3. Brouillette RT, Fembach SK, Hunt CE. Obstructive sleep apnea in infants and children. J Pediatr 1982;100:31-40 https://doi.org/10.1016/S0022-3476(82)80231-X
  4. Marcus CL. Sleep-disordered breathing in children. Am J Respir Crit Care Med 2001;164:16-30 https://doi.org/10.1164/ajrccm.164.1.2008171
  5. Goldstein NA, Fatima M, Campbell TF, Rosenfeld RM. Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg 2002;128:770-5 https://doi.org/10.1001/archotol.128.7.770
  6. Rosen CL, Palermo TM, Larkin EK, Redline S. Health-related quality of life and sleep-disordered breathing in children. Sleep 2002;25:657-66
  7. Flanary VA. Long-term effect of adenotonsillectomy on quality of life in pediatric patients. Laryngoscope 2003;113:1639-44 https://doi.org/10.1097/00005537-200310000-00003
  8. Franco RA Jr, Rosenfeld RM, Rao M. Quality of life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg 2000;123:9-16 https://doi.org/10.1067/mhn.2000.105254
  9. Rechtschaffen A, Kates A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Los Angeles: Brain lnformation Service/Brain Research Institute, UCLA; 1968
  10. Bonzanigo C. Adenotonsillectomy as a cure for sleep apnea syndrome in a 5-year-old boy. Helv Paediatr Acta 1984;39:193-6
  11. Friedman BC, Hendeles-Amitai A, Kozminsky E, Leiberman A, Friger M, Tarasiuk A, et al. Adenotonsillectorny improves neurocognitive function in children with obstructive sleep apnea syndrome. Sleep 2003;26:999-1005 https://doi.org/10.1093/sleep/26.8.999
  12. Tarasiuk A, Simon T, Tal A, Reuveni H. Adenotonsillectomy in children with obstructive sleep apnea syndrome reduces health care utilization. Pediatrics 2004;113:351-6 https://doi.org/10.1542/peds.113.2.351
  13. Georgalas C, Tolley N, Kanagalingam J. Measuring quality of life in children with adenotonsillar disease with the child health questionnaire: A first U.K. study. Laryngoscope 2004;114:1849-55 https://doi.org/10.1097/00005537-200410000-00032
  14. American Thoracic Society. Standard and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 1996;153:866-78 https://doi.org/10.1164/ajrccm.153.2.8564147
  15. Kay DJ, Mehta V, Goldsmith AJ. Perioperative adenotonsillectomy management in children: Current practices. Laryngoscope 2003;113:592-7 https://doi.org/10.1097/00005537-200304000-00002
  16. Uliel S, Tauman R, Greenfeld M, Sivan Y. Normal polysomnographic respiratory values in children and adolescents. Chest 2004;125:872-8 https://doi.org/10.1378/chest.125.3.872