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논문KCI 등재

소아 폐쇄성 수면무호흡증후군

Pediatric Obstructive Sleep Apnea Syndrome

김민정|김성완
대한 소아알레르기 호흡기학회 (The Korean Academy Of Pediatric Allergy And Respiratory Disease)|2006.06|Allergy Asthma & Respiratory Disease (알레르기 천식 호흡기질환)|제16권 제2호|pp. 102-113

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참고문헌

주제분류소아과학

초록

소아에게서 폐쇄성 수면무호흡증은 약 1-3%의 빈도로 일어나는 비교적 흔한 질환임에도 불구하고 흔히 간과 되어왔다. 질환을 조기에 진단하여 적절한 시기에 치료되지 못할 경우 심혈관계 장애, 학습장애, 행동장애, 신경인지기능 발달장애, 성장장애와 같은 합병증을 유발할 수 있다. 소아는 급격히 변화하는 성장기에 있기 때문에, 수면 중 성인에 비해 상대적으로 적은 혈중 산소나 탄산가스의 변화와 적은 각성빈도에 의해서도 영향을 많이 받는 것으로 생각되므로 모든 소아에게서 수면호흡장애에 대한 선별검사를 하는 것이 바람직하다. 진단은 병력청취와 이학적 검사를 바탕으로 하여 다양한 검사방법이 소개되고 있으나 가장 표준이 되는 검사는 야간 수면다원검사이다. 진단 시 소아에서는 병력 및 이학적 검사, 수면다원검사를 비롯한 다양한 검사 결과와 판독 기준이 성인과 다르므로 그 차이를 고려하여 진단되어야 한다. 치료는 편도 및 아데노이드 비대가 있는 경우 제거수술을 통해 대부분 호전이 가능하나 고위험군의 환자인 경우 장기간의 추적관찰과 추가적인 검사, 부가적인 치료 방법 등을 고려해야 할 것이다.

Abstract

Obstructive sleep apnea syndrome(OSAS) is a frequent, but underdiagnosed problem in children. If it is left untreated, OSAS may lead to substantial morbidities affecting multiple target organs and systems. The immediate consequences of OSAS in children include behavioral disturbance and learning deficits, pulmonary hypertension, as well as compromised somatic growth. If it is not treated promptly and early in the course of the disease, OSAS may also impose long term adverse effect on neurocognitive and cardiovascular function. Therefore, all children is recommended to be screened for snoring and/or sleep apnea. Diagnostic evaluation, such as polysomnography, is useful and gold standard in discriminating between primary snoring and OSAS. Adenotosillectomy is the fist line of treatment for most children, otherwise continuous positive airway pressure(CPAP) is the first line of treatment in adults. CPAP is an option for those who are not candidates for surgery or do not respond to surgery. High risk patients should be monitored postoperatively. And patients with OSAS should be reevaluated postoperatively to determine whether additional treatment is required.

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