Comparison of the sleep architecture and symptom of inattention-hyperactivity in children with obstructive sleep apnea hypopnea syndrome before and after surgery
10.3321/j.issn:1673-0860.2008.03.003
- VernacularTitle:阻塞性睡眠呼吸暂停低通气综合征儿童手术前后注意力缺陷和多动症状
- Author:
Zhen-Yun HUANG
1
;
Da-Bo LIU
;
Zhibin LI
;
Jian-Wen ZHONG
;
Jie YU
;
Zong-Yu TAN
;
Chang-Zhi SUN
;
Li-Fen ZHOU
;
Qian CHEN
Author Information
1. 广州市儿童医院
- Keywords:
Sleep apnea,obstructive;
Child;
Attention deficit disorder with hyperactivity
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2008;43(3):169-173
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the symptoms of inattention,hyperactivity among obstructive sleep apnea hypopnea syndrome(OSAHS) children,also to investigate the effects of surgery(tonsillectomy and adenoidectomy or adenoidectomy alone)on the changes of sleep architecture and inattention-hyperactivity score(HIS). Methods Between June 2004 and may 2007,eighty children diagnosed as OSAHS with overnight polysomnography(PSG) were included in this study,only sixteen children had complete pre-op and post-op PSG data. Thirty children with vocal cord nodules were selected as control group. DSM-Ⅳ-derived HIS was evaluated by neurologist. All OSAHS children accepted surgery(tonsillectomy and adenoidectomy or adenoidectomy alone) and HIS evaluation. The pre-op and post-op sleep architecture and than that it in control group(0.89 vs 0.17)and the difference was significant(Z=-4.276,P＜0.05).OSAHS children had pre-op HIS greater than 1.25 and nine had post-op HIS greater than 1.25,while only three children in control group had HIS greater than 1.25. The difference was statistically significant(x2=data,a decrease in the percentage of phase 1 sleep and an increase in the percentage of phase 2 sleep,slow wave sleep(SWS) and rapid eye movement(REM) sleep were observed in six months after surgery and the difference was significant(t=12.2,-5.4,-6.3,-8.1 respectively,P＜0.001). After surgery,apneahypopnea index(AHI) decreased from 13.9 times/h to 1.5 times/h while lowest saturation of blood oxygen (LSaO2) increased from 0.855 to 0.940(t=5.3,-3.7 respectively,P＜0.01). REM sleep percentage and LSaO2 was still lower than that of control group six months after surgery. Conclusions Children with OSAHS showed significantly impaired attention and hyperactivity as compared with control group.Improvement of behavior and sleep architecture were observed after dnoidectomy and tonsillectomy.
