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Uyku apnesi saptanan Down sendrom’lu hastalarda solunum Destek cihazı uyumunun değerlendirilmesi

Year 2021, Volume: 54 Issue: 1, 54 - 58, 27.04.2021

Abstract

AMAÇ: Obstruktif uyku apne sendromu Down Sendromlu çocuklarda sıklıkla izlenmektedir ve önemli bir morbidite nedenidir. Bu çalışmada Down Sendromu tanısı ile izlenen ve uyku apnesi nedeni ile solunum destek cihazı kullanan hastaların demografik özellikleri, polisomnografik karakteristikleri ve non-invaziv solunum destek tedaviye olan uyum düzeylerinin değerlendirilmesi amaçlandı.
GEREÇ VE YÖNTEMLER: 2016-2019 yılları arasında Down Sendromu tanısı ile izlenmekte olan ve Hacettepe Üniversitesinde yapılan polisomnografi sonrasında solunum destek cihazı önerilen ve en az bir yıldır cihaza sahip hastalar çalışmaya dahil edildi. Kayıtları retrospektif olarak incelendi ve demografik özellikleri, polisomongrafik karakteristikleri ve solunum destek cihazı uyumları araştırıldı.
BULGULAR: En az bir yıldır solunum destek cihazına sahip olan 20 Down Sendromlu hasta çalşmaya dahil edildi. Hastaların yaş ortalaması 4.45±4.09 idi. Hastaların 14’ünde (%60,9) horlama, 11’inde apne (%47.8) ve 11’inde ( 47.8) gece sık uyanma şikayeti vardı. Hastaların 5’inde (%25) PSG öncesi adenotonsillektomi öyküsü mevcut idi. Polisomnografi sonucunda hastaların 3’ünde orta ve 17’sinde ağır obstruktif uyku apne sendromu saptandı. Ortalama apne-hipopne indeksi değeri 33.26±46.87 olarak tespit edildi. Bir yıllık dönemde hastaların %30’un non-invazif uyumunun iyi (>4 saat/gece) olduğu saptandı.
TARTIŞMA: Çalışmamız down sendromlu çocuklarda her yaşta solunum desteği gerektirecek uyku apnesinin görüldüğünü ve bu durumun bazı hastalarda asemptomatik olabileceğini göstermektedir. Çalışmamızda hastaların sadece %30’unda uzun dönemde non-invazif alet uyumunun yeterli olduğunu görmelmektedir.

References

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  • 3. Maris M, Verhulst S, Wojciechowski M,et al. Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome. Sleep. 2016;39(3):699-704.
  • 4. Lal C, White DR, Joseph JE,et al. Sleep-disordered breathing in Down syndrome. Chest. 2015;147(2):570-9.
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  • 13. Shete MM, Stocks RM, Sebelik ME,et al. Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: a comparative study with children without Down syndrome. Int J Pediatr Otorhinolaryngol. 2010;74(3):241-4.
  • 14. Luijks KA, Vandenbussche NL, Pevernagie D,et al. Adherence to continuous positive airway pressure in adults with an intellectual disability. Sleep Med. 2017;34:234-9.
  • 15. Hawkins SM, Jensen EL, Simon SL,et al. Correlates of Pediatric CPAP Adherence. J Clin Sleep Med. 2016;12(6):879-84.
  • 16. Berry RB, Gamaldo CE, Harding SM, et al. AASM Scoring Manual Version 2.2 Updates: New Chapters for Scoring Infant Sleep Staging and Home Sleep Apnea Testing. J Clin Sleep Med. 2015;11(11):1253-4.
  • 17. Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012;8(5):597-619.
  • 18. Trucco F, Chatwin M, Semple T,et al. Sleep disordered breathing and ventilatory support in children with Down syndrome. Pediatr Pulmonol. 2018;53(10):1414-21.
  • 19. Dudoignon B, Amaddeo A, Frapin A, et al. Obstructive sleep apnea in Down syndrome: Benefits of surgery and noninvasive respiratory support. Am J Med Genet A. 2017;173(8):2074-80.
  • 20. Shott SR, Amin R, Chini B,et al. Obstructive sleep apnea: Should all children with Down syndrome be tested? Arch Otolaryngol Head Neck Surg. 2006;132(4):432-6.
Year 2021, Volume: 54 Issue: 1, 54 - 58, 27.04.2021

Abstract

References

  • 1. McDowell KM, Craven DI. Pulmonary complications of Down syndrome during childhood. J Pediatr. 2011;158(2):319-25.
  • 2. Churchill SS, Kieckhefer GM, Landis CA,et all. Sleep measurement and monitoring in children with Down syndrome: a review of the literature, 1960-2010. Sleep Med Rev. 2012;16(5):477-88.
  • 3. Maris M, Verhulst S, Wojciechowski M,et al. Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome. Sleep. 2016;39(3):699-704.
  • 4. Lal C, White DR, Joseph JE,et al. Sleep-disordered breathing in Down syndrome. Chest. 2015;147(2):570-9.
  • 5. de Graaf G, Buckley F, Skotko BG. Estimates of the live births, natural losses, and elective terminations with Down syndrome in the United States. Am J Med Genet A. 2015;167A(4):756-67.
  • 6. Waters KA, Castro C, Chawla J. The spectrum of obstructive sleep apnea in infants and children with Down Syndrome. Int J Pediatr Otorhinolaryngol. 2020;129:109763.
  • 7. Brockmann PE, Damiani F, Nunez F, et al. Sleep-disordered breathing in children with Down syndrome: Usefulness of home polysomnography. Int J Pediatr Otorhinolaryngol. 2016;83:47-50.
  • 8. de Miguel-Diez J, Villa-Asensi JR, Alvarez-Sala JL. Prevalence of sleep-disordered breathing in children with Down syndrome: polygraphic findings in 108 children. Sleep. 2003;26(8):1006-9.
  • 9. Howard JJM, Sarber KM, Yu W, , et al. Outcomes in children with down syndrome and mild obstructive sleep apnea treated non-surgically. Laryngoscope. 2020;130(7):1828-35.
  • 10. Goffinski A, Stanley MA, Shepherd N, et al. Obstructive sleep apnea in young infants with Down syndrome evaluated in a Down syndrome specialty clinic. Am J Med Genet A. 2015;167A(2):324-30.
  • 11. Bull MJ, Committee on G. Health supervision for children with Down syndrome. Pediatrics. 2011;128(2):393-406.
  • 12. Maris M, Verhulst S, Wojciechowski M,et al. Outcome of adenotonsillectomy in children with Down syndrome and obstructive sleep apnoea. Arch Dis Child. 2017;102(4):331-6.
  • 13. Shete MM, Stocks RM, Sebelik ME,et al. Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: a comparative study with children without Down syndrome. Int J Pediatr Otorhinolaryngol. 2010;74(3):241-4.
  • 14. Luijks KA, Vandenbussche NL, Pevernagie D,et al. Adherence to continuous positive airway pressure in adults with an intellectual disability. Sleep Med. 2017;34:234-9.
  • 15. Hawkins SM, Jensen EL, Simon SL,et al. Correlates of Pediatric CPAP Adherence. J Clin Sleep Med. 2016;12(6):879-84.
  • 16. Berry RB, Gamaldo CE, Harding SM, et al. AASM Scoring Manual Version 2.2 Updates: New Chapters for Scoring Infant Sleep Staging and Home Sleep Apnea Testing. J Clin Sleep Med. 2015;11(11):1253-4.
  • 17. Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012;8(5):597-619.
  • 18. Trucco F, Chatwin M, Semple T,et al. Sleep disordered breathing and ventilatory support in children with Down syndrome. Pediatr Pulmonol. 2018;53(10):1414-21.
  • 19. Dudoignon B, Amaddeo A, Frapin A, et al. Obstructive sleep apnea in Down syndrome: Benefits of surgery and noninvasive respiratory support. Am J Med Genet A. 2017;173(8):2074-80.
  • 20. Shott SR, Amin R, Chini B,et al. Obstructive sleep apnea: Should all children with Down syndrome be tested? Arch Otolaryngol Head Neck Surg. 2006;132(4):432-6.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original research article
Authors

Mina Garibzadeh Hızal 0000-0002-6922-4948

Sanem Eryılmaz Polat This is me 0000-0003-2309-7952

Nagehan Emiralioğlu 0000-0002-1405-8401

Dilber Ademhan Tural 0000-0002-0334-6336

Beste Özsezen 0000-0002-0052-8361

Birce Sunman This is me 0000-0001-9818-8782

Onur Gözmen 0000-0003-1756-1288

Ebru Yalçın 0000-0003-1756-1288

Deniz Doğru 0000-0001-9931-9473

Nural Kiper This is me 0000-0003-1261-7393

Uğur Özçelik This is me 0000-0003-1587-5216

Publication Date April 27, 2021
Submission Date December 23, 2020
Published in Issue Year 2021 Volume: 54 Issue: 1

Cite

AMA Garibzadeh Hızal M, Eryılmaz Polat S, Emiralioğlu N, Ademhan Tural D, Özsezen B, Sunman B, Gözmen O, Yalçın E, Doğru D, Kiper N, Özçelik U. Uyku apnesi saptanan Down sendrom’lu hastalarda solunum Destek cihazı uyumunun değerlendirilmesi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. April 2021;54(1):54-58.