Banhara Fábio Luiz, Trindade Inge Elly Kiemle, Trindade-Suedam Ivy Kiemle, Fernandes Marilyse de Bragança Lopes, Trindade Sergio Henrique Kiemle
Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil.
Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Bauru, SP, Brazil.
Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 1(Suppl 1):S133-S141. doi: 10.1016/j.bjorl.2021.05.002. Epub 2021 May 28.
Obstructive sleep apnea is highly prevalent in non-syndromic Pierre Robin sequence patients. Studies have found a probable relationship between obstructive sleep apnea and nasal obstruction and between obstructive sleep apnea and enuresis. Assessment of the relationship between these variables in non-syndromic Pierre Robin sequence patients is scarce.
The present study aims to evaluate the relationship between symptoms of obstructive sleep apnea, nasal obstruction and enuresis, determining the prevalence of symptoms suggestive of these conditions, in schoolchildren with non-syndromic Pierre Robin sequence, and describe the prevalence of excessive daytime sleepiness habitual snoring and voiding dysfunction symptoms associated with enuresis.
This was a prospective analytical cross-sectional study developed at a reference center. Anthropometric measurements and a structured clinical interview were carried out in a sample of 48 patients. The instruments "sleep disorders scale in children" "nasal congestion index questionnaire" (CQ-5), and the "voiding dysfunction symptom score questionnaire" were used. Statistical analysis was performed for p < 0.05.
Positive "sleep disorders scale in children" scores for obstructive sleep apnea and CQ-5 for nasal obstruction were observed in 38.78% and 16.33%, respectively. Enuresis was reported in 16.33% of children, being characterized as primary in 71.43% and polysymptomatic in 55.55%; according to the "voiding dysfunction symptom score questionnaire". There was a significant relationship between nasal obstruction and obstructive sleep apnea symptoms (p < 0.05), but no significance was found between obstructive sleep apnea symptoms and enuresis, and between nasal obstruction and enuresis. The prevalence of excessive daytime sleepiness was 12.24% and of habitual snoring, 48.98%. A family history of enuresis, younger age in years and a positive "voiding dysfunction symptom score questionnaire" score were associated with a higher prevalence of enuresis (p < 0.05).
Children with non-syndromic Pierre Robin sequence are at high risk for obstructive sleep apnea symptoms and habitual snoring, with a correlation being observed between nasal obstruction and obstructive sleep apnea symptoms. In addition, the study showed that non-syndromic Pierre Robin sequence, obstructive sleep apnea and nasal obstruction symptoms were not risk factors for enuresis in these patients.
阻塞性睡眠呼吸暂停在非综合征性皮埃尔·罗宾序列征患者中极为常见。研究发现阻塞性睡眠呼吸暂停与鼻阻塞之间以及阻塞性睡眠呼吸暂停与遗尿之间可能存在关联。对非综合征性皮埃尔·罗宾序列征患者中这些变量之间关系的评估较为匮乏。
本研究旨在评估阻塞性睡眠呼吸暂停症状、鼻阻塞与遗尿之间的关系，确定非综合征性皮埃尔·罗宾序列征学龄儿童中提示这些病症的症状患病率，并描述与遗尿相关的日间过度嗜睡、习惯性打鼾和排尿功能障碍症状的患病率。
这是一项在参考中心开展的前瞻性分析横断面研究。对48例患者进行了人体测量和结构化临床访谈。使用了“儿童睡眠障碍量表”“鼻充血指数问卷”（CQ - 5）以及“排尿功能障碍症状评分问卷”。进行了p < 0.05的统计学分析。
分别有38.78%和16.33%的患者“儿童睡眠障碍量表”中阻塞性睡眠呼吸暂停评分及鼻阻塞CQ - 5评分呈阳性。16.33%的儿童报告有遗尿，根据“排尿功能障碍症状评分问卷”，其中71.43%为原发性遗尿，55.55%为多症状性遗尿。鼻阻塞与阻塞性睡眠呼吸暂停症状之间存在显著关联（p < 0.05），但阻塞性睡眠呼吸暂停症状与遗尿之间以及鼻阻塞与遗尿之间未发现显著关联。日间过度嗜睡的患病率为12.24%，习惯性打鼾的患病率为48.98%。遗尿家族史、年龄较小以及“排尿功能障碍症状评分问卷”评分呈阳性与遗尿患病率较高相关（p < 0.05）。
非综合征性皮埃尔·罗宾序列征儿童存在阻塞性睡眠呼吸暂停症状和习惯性打鼾的高风险，鼻阻塞与阻塞性睡眠呼吸暂停症状之间存在相关性。此外，研究表明非综合征性皮埃尔·罗宾序列征、阻塞性睡眠呼吸暂停和鼻阻塞症状并非这些患者遗尿的危险因素。
