Abstract
Seventy-eight prepubertal children 3 to 10 years old (mean age 5,67 years,
range 2.4 - 10.5 years), with symptoms suggestive of obstructive sleep apnea
syndrome (OSAS) were studied. Based on overnight polysomnography (PSG) results,
32 children were classified as having OSAS, whereas 46 children were considered
as primary snorers (PSs'), when an obstructive apnea-hypopnea index
(AHIO) of over one was considered abnormal. Symptoms,
signs and findings in these two groups were compared in a cross-sectional study.
Fifty-eight of the children were retrieved for a follow-up visit, which was
scheduled six months from the first visit. The children with an initial
AHIO of 2 or over (n = 21) had been subjected to
adenotonsillectomy swiftly after the first visit, whereas the others (n = 37)
were observed without intervention. The changes in symptoms, signs and findings
were analysed within and between these groups.
Relative risk (RR) ratios were calculated in order to find clinical
symptoms and signs predicting OSAS in snoring children. Observed apneas, restless
sleep, constant snoring and tonsillar hypertrophy were significantly associated
with an increased risk of OSAS.
Dental arch measurements indicated that AHIO was
significantly associated with the amount of overjet, suggesting that altered
breathing may affect the dentofacial morphology.
Nasalance measurements revealed no group differences between the OSAS
children and PSs'. Adenotonsillectomy had no significant influence on the
nasalence scores. Measurements of nasalance seem to contribute little to the
diagnostics of OSAS in children.
At the first visit the mean circulating concentrations of insulin-like
growth factor-1 (IGF-1) were of the same magnitude in the OSAS children, the PSs'
and the age-matched control group, but both the OSAS children and the PSs' had
lower IGF-binding protein-3 (IGFBP-3) concentrations than the control subjects.
At the second visit a significant increase of the peripheral concentrations of
IGF-1 and IGFBP-3, along with increases in weight for height and BMI were
observed in the surgically treated children, whose respiratory parameters and
symptoms had improved highly significantly, as well. These results indicate that
the growth of children with obstructed nighttime breathing is potentially
affected through impaired growth hormone secretion.
None of the primary snorers developed OSAS during the observation period,
which finding suggests a favorable prognosis for primary snoring in children.
| Identifer | oai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-6655-2 |
| Date | 03 May 2002 |
| Creators | Nieminen, P. (Peter) |
| Publisher | University of Oulu |
| Source Sets | University of Oulu |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess, © University of Oulu, 2002 |
| Relation | info:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234 |
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