Apneia obstrutiva do sono em crianças e adolescentes com asma: existe diferença entre os sexos?
Data
2021-07-01
Orientadores
Moreira, Gustavo Antonio 
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: comparar a frequência de apneia obstrutiva do sono em meninos e meninas com asma. Métodos: foram selecionados 80 voluntários asmáticos com idade entre 7 e 18 anos incompletos. Os voluntários responderam questionários, foram examinados e realizaram prova de função pulmonar e poligrafia domiciliar (tipo III). Resultados: a idade média dos voluntários foi 11,6 anos, 51,3% do sexo feminino, 82,5% com rinite moderada/grave, 18,5% obesos, 21% em estágio pré puberal. Asma leve, moderada e grave foi observada em 4, 10 e 86% dos voluntários, respectivamente. Estavam controlados da asma em curto prazo 43,7% e em longo prazo, 33,7% dos voluntários. Distúrbio ventilatório obstrutivo leve foi observado em 30 voluntários e moderado, em 2. A mediana do índice de eventos respiratórios obstrutivos foi 1,8 eventos/h. Apneia obstrutiva do sono foi encontrada em 62,5% da amostra. Não houve diferença na distribuição do apneia considerando-se: sexo, estágio puberal, gravidade ou controle da asma ou gravidade da rinite. Não foi observada interação entre o Índice de Eventos Respiratórios Obstrutivos e sexo, z escore do índice de massa corporal, classificação da asma, níveis de controle da asma, diagnóstico de rinite, de refluxo gastroesofágico ou com o volume expiratório forçado no primeiro segundo. O questionário TuCASA (ponto de corte de 8) foi preditor da apneia do sono moderada/grave. Estar controlado da asma no último mês associou-se a menos crises de asma nos últimos 12 meses, enquanto estar controlado da asma em curto e longo prazo associou-se a menos internações por asma nos últimos 12 meses. Conclusões: encontramos apneia obstrutiva do sono em 62,5% de nossos voluntários (em 75% dos meninos e em 57,5% das meninas). Não observamos outros fatores associados à apneia obstrutiva do sono em nossa amostra, além do questionário TuCASA (valor maior ou igual a 8) para apneia moderada/grave. O controle da asma em curto e longo prazo estão associados aos desfechos de número de crises de asma e de internação por asma nos 12 meses anteriores. O questionário TuCasa como preditor de apneia do sono moderada/grave tem grande utilidade na prática clínica uma vez que estudos do sono em crianças são de difícil acesso devido à falta de leitos, custo e poucos profissionais capacitados ao atendimento pediátrico.
Objective: Compare the frequency of obstructive sleep apnea among boys and girls with asthma. Methods: 80 asthmatic children, 7 to 18 years were selected. Volunteers were submitted to questionnaires, physical examination, pulmonary function tests, and home polygraphy (type III). Results: Mean age was 11.6 years, 51.3% female, 82.5% with moderate/severe rhinitis, 18.5% with obesity, 21% in pre-pubertal stage. Mild, moderate, and severe asthma was found in 4, 10, and 86%, respectively. Asthma control in short and long term was observed in 43.7% and 33.7%. Mild and moderate obstructive ventilatory disorder was observed in 30 and 2 volunteers, respectively. Mean total obstructive respiratory events index was 1.8 events/h. Obstructive sleep apnea was observed in 62.5% of our sample. There was no difference in terms of sex, pubertal stage, severity or asthma control, or rhinitis’ severity. We did not find an association among the Obstructive Respiratory Events Index and sex, body mass index z score, asthma classification or control, rhinitis’ severity, gastroesophageal reflux or forced expiratory flow in the first second. The TuCasa questionnaire (cut point of 8) was predictor of moderate/severe apnea. Being controlled for asthma in the previous month was associated with being controlled in the last year. Being controlled in short and long term was associated with less hospital admissions in the previous year. Conclusions: obstructive sleep apnea was found in 62.5% of our sample (75% of boys and 57.5% of girls with apnea). We did not find other risk factors for obstructive sleep apnea in our sample except for the TuCasa questionnaire (cut point of 8) for moderate/severe apnea. Being controlled for asthma in short and long term was associated with fewer asthma attacks and less need of hospital admissions on the previous year. TuCASA questionnaire as a good predictor for moderate/severe asthma is highly important for clinical practice since pediatric sleep studies are scarce due to cost, availability of bed, and lack of pediatric trained professionals.
Objective: Compare the frequency of obstructive sleep apnea among boys and girls with asthma. Methods: 80 asthmatic children, 7 to 18 years were selected. Volunteers were submitted to questionnaires, physical examination, pulmonary function tests, and home polygraphy (type III). Results: Mean age was 11.6 years, 51.3% female, 82.5% with moderate/severe rhinitis, 18.5% with obesity, 21% in pre-pubertal stage. Mild, moderate, and severe asthma was found in 4, 10, and 86%, respectively. Asthma control in short and long term was observed in 43.7% and 33.7%. Mild and moderate obstructive ventilatory disorder was observed in 30 and 2 volunteers, respectively. Mean total obstructive respiratory events index was 1.8 events/h. Obstructive sleep apnea was observed in 62.5% of our sample. There was no difference in terms of sex, pubertal stage, severity or asthma control, or rhinitis’ severity. We did not find an association among the Obstructive Respiratory Events Index and sex, body mass index z score, asthma classification or control, rhinitis’ severity, gastroesophageal reflux or forced expiratory flow in the first second. The TuCasa questionnaire (cut point of 8) was predictor of moderate/severe apnea. Being controlled for asthma in the previous month was associated with being controlled in the last year. Being controlled in short and long term was associated with less hospital admissions in the previous year. Conclusions: obstructive sleep apnea was found in 62.5% of our sample (75% of boys and 57.5% of girls with apnea). We did not find other risk factors for obstructive sleep apnea in our sample except for the TuCasa questionnaire (cut point of 8) for moderate/severe apnea. Being controlled for asthma in short and long term was associated with fewer asthma attacks and less need of hospital admissions on the previous year. TuCASA questionnaire as a good predictor for moderate/severe asthma is highly important for clinical practice since pediatric sleep studies are scarce due to cost, availability of bed, and lack of pediatric trained professionals.
Descrição
Citação
SANTOS, Cristiane Fumo dos. Apneia obstrutiva do sono em crianças e adolescentes com asma: existe diferença entre os sexos? São Paulo, 2021. 232 f. Dissertação (Mestrado em Psicobiologia) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2021.