소아 수면호흡장애의 예측 인자 평가
Assessment of Predicting Factors for Pediatric Sleep Disordered Breathing
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
이 연구의 목적은 수면호흡장애를 가진 어린이들을 선별하기 위해 휴대용 간이수면검사를 이용한 무호흡 저호흡 지수(apneahypopnea index, AHI)를 기준으로, 치과 진료실에서 사용 가능한 측모두부계측 방사선 사진, 임상 검사, 소아수면설문지(pediatric sleep questionnaire, PSQ)에서 유용한 수치들을 찾아내고 평가하는 것이었다. 교정치료를 위해 전북대학교 소아치과에 내원한 5 - 10세의 어린이들을 대상으로 하였다. 총 61명이 이 연구에 포함되었으며, AHI 값이 1보다 크게 나타난 어린이들을 SDB군으로, 1 이하로 나타난 어린이들은 정상군으로 분류하였다. 61명의 어린이 중 49(80%)명이 SDB군에 포함되었다. SDB군과 정상군과의 통계 분석 결과, 휴대용 간이수면검사의 ODI(oxygen dehydration index)와 코골이 시간, 설문지를 통한 PSQ scale, 측모두부계측 방사선 사진에서 아데노이드 비대율과 하악평면에서 설골까지의 거리 그리고 gonial angel이 통계적으로 유의한 차이를 보였다. 이 연구를 통해 잠재적인 SDB 환자를 선별해내기 위해 측모두부계측 방사선 사진을 통한 아데노이드 비대, 설골의 위치, gonial angle과 소아수면설문지를 평가하는 것이 유용할 것으로 보인다.
Abstract
The aim of this study was to evaluate the association between various predicting tools and Apnea-Hypopnea Index (AHI) to identify children with sleep disordered breathing (SDB). From 5 to 10 years old who came for orthodontic counseling, 61 children, whom had lateral cephalograms, pediatric sleep questionnaire (PSQ) records, and portable sleep monitoring results, were included in this study. A total of 17 measurements (11 distances and 6 angles) were made on lateral cephalograms. The measurements of lateral cephalograms, PSQ scales and portable sleep monitoring results were statistically analyzed. 49 of 61 (80%) patients showed AHI > 1, which suspected to have SDB and their mean AHI was 2.75. In this study, adenoid size (A/N ratio), position of the hyoid bone from mandibular plane, gonial angle, and PSQ scale were related to a higher risk of pediatric SDB. Also, oxygen desaturation index (ODI) and snoring time from sleep monitoring results were statistically significant in children with SDB using Mann-Whitney test (p ＜ 0.05). In conclusion, evaluation of hyoid bone position, adenoidal hypertrophy, gonial angle in lateral cephalogram, and PSQ scale was important to screen out potential SDB, especially in children with frequent snoring.
참고문헌 (34)
- Marcus CL, "Sleep-disordered breathing in children", Am J Respir Crit Care Med, 164, pp.16~30 (2001)
- Kaditis AG, "Obstructive sleep disordered breathing in 2-to 18-year-old children : diagnosis and management", Eur Respir J, 47, pp.69~94 (2016)
- Berry RB, "AASM scoring manual version 2.2 updates: new chapters for scoring infant sleep staging and home sleep apnea testing", J Clin Sleep Med, 11, pp.1253~1254 (2015)
- 이승훈, "소아 폐쇄성 수면무호흡증후군의 이해", Hanyang Medical Reviews, 33(4), pp.246~252 (2013), 한양대학교 의과대학[DOI]
- Tan HL, "Pediatric Home Sleep Apnea Testing Slowly Getting There!", Chest, 148, pp.1382~1395 (2015)
- Certal V, "Model for Prediction of Pediatric OSA : Proposal for a Clinical Decision Rule", Laryngoscope, 125, pp.2823~2827 (2015)
- Chervin RD, "Pediatric sleep questionnaire(PSQ) : validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems", Sleep Med, 1, pp.21~32 (2000)
- 강은경, "폐쇄성수면무호흡증후군 선별을 위한 소아용 수면설문지", Allergy Asthma & Respiratory Disease, 7(3), pp.122~128 (2019), 대한 소아알레르기 호흡기학회
- Fujioka M, "Radiographic evaluation of adnoidal size in children : adenoidal-nasopharyngeal ratio", AJR Am J Roentgenol, 133, pp.401~404 (1979)
- 황상희, "성별에 따른 폐쇄성 수면무호흡 환자의 측모 두부방사선계측학적 관련요인", 대한치과교정학회지, 41(3), pp.164~173 (2011), 대한치과교정학회
- 김도영, "소아 수면호흡장애의 진단과 상악확장술의 치료효과", 대한소아치과학회지, 46(4), pp.369~381 (2019), 대한소아치과학회[DOI]
- Macari AT, "Correlation Between the Position of the Hyoid Bone on Lateral Cephalographs and Formant Frequencies", J Voice, 30, pp.757~ (2016)
- Gipson K, "Sleep-Disordered Breathing in Children", Pediatr Rev, 40, pp.3~13 (2019)
- Luzzi V, "A Review of Pediatric Obstructive Sleep Apnea and the Role of the Dentist", Eur Rev Med Pharmacol Sci, 23(1 Suppl), pp.9~14 (2019)
- Uliel S, "Normal polysomnographic respiratory values in children and adolescents", Chest, 125, pp.872~878 (2004)
- Collop NA, "Clinical Guidelines for the Use of Unattended Portable Monitors in the Diagnosis of Obstructive Sleep Apnea in Adult Patients Portable Monitoring Task Force of the American Academy of Sleep Medicine", J Clin Sleep Med, 3, pp.737~747 (2007)
- Marcus CL, "Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome", Pediatrics, 130, pp.576~584 (2012)
- Alonso-Álvarez ML, "Reliability of home respiratory polygraphy for the diagnosis of sleep apnea in children", Chest, 147, pp.1020~1028 (2015)
- Rohra AK Jr, "Sleep disordered breathing in children seeking orthodontic care", Am J Orthod Dentofacial Orthop, 154, pp.65~71 (2018)
- Patil SP, "Adult obstructive sleep apnea : pathophysiology and diagnosis", Chest, 132, pp.325~337 (2007)
- Ryu HH, "The usefulness of cephalometric measurement as a diagnostic tool for obstructive sleep apnea syndrome : a retrospective study", Oral Surg Oral Med Oral Pathol Oral Radiol, 119, pp.20~31 (2015)
- Flores-Mir C, "Craniofacial morphological characteristics in children with obstructive sleep apnea Syndrome", J Am Dent Assoc, 144, pp.269~277 (2013)
- Katyal V, "Craniofacial and upper airway morphology in pediatric sleep-disordered breathing: Systematic review and meta-analysis", Am J Orthod Dentofacial Orthop, 143, pp.20~30.e3 (2013)
- Chi L, "Identification of craniofacial risk factors for obstructive sleep apnoea using three dimensional MRI", Eur Respir J, 38, pp.348~358 (2011)
- Lowe AA, "Cephalometric and demographic characteristics of obstructive sleep apnea : an evaluation with partial least squares analysis", Angle Orthod, 67, pp.143~153 (1997)
- 김도영, "구호흡 어린이에서 수면호흡장애와 상기도와의 관계", 대한소아치과학회지, 46(1), pp.38~47 (2019), 대한소아치과학회[DOI]
- Tangugsorn V, "Obstructive sleep apnoea : multiple comparisons of cephalometric variables of obese and non-obese patients", J Craniomaxillofac Surg, 28, pp.204~212 (2000)
- Paoli JR, "Craniofacial differences according to the body mass index of patients with obstructive sleep apnoea syndrome : cephalometric study in 85 patients", Br J Oral Maxillofac Surg, 39, pp.40~45 (2001)
- Yashmin S, "Role of hyoid bone in obstructive sleep apnea", Int J Curr Res, 10, pp.68063~68066 (2018)
- Ikävalko T, "Predictors of sleep disordered breathing in children: the PANIC study", Eur J Orthod, 40, pp.268~272 (2018)
- Papaioannou G, "Age-dependent changes in the size of adenotonsillar tissue in childhood:implications for sleep-disordered breathing", J Pediatr, 162, pp.269~274.e4 (2013)
- Brunetti L, "Prevalence of obstructive sleep apnea syndrome in a cohort of 1, 207 children of southern Italy", Chest, 120, pp.1930~1935 (2001)
- Kang KT, "Associations between Adenotonsillar Hypertrophy, Age, and Obesity in Children with Obstructive Sleep Apnea", PLoS One, 8, pp.e78666~ (2013)
- Nolan J, "Systematic Review of Pediatric Tonsil Size and Polysomnogram-Measured Obstructive Sleep Apnea Severity", Otolaryngol Head Neck Surg, 144, pp.844~850 (2011)