Main Article Content
Abstract
Introduction. Le Syndrome d’Apnées Hypopnées Obstructives du Sommeil (SAHOS) est le trouble respiratoire le plus fréquent lié au sommeil chez l’enfant. L’objectif de ce travail était de déterminer la prévalence et les facteurs associés au SAHOS chez les enfants et adolescents vus en consultation d’oto-rhino-laryngologie (ORL) à Cotonou. Méthodes. Il s’agit d’une étude transversale, descriptive et analytique qui s’est déroulée du 06 août au 30 novembre 2018 dans les services d’ORL du Centre Hospitalier Universitaire de Zone de Suru-Léré et du centre médical Avicennes de Cotonou. Le recrutement a été non probabiliste de commodité chez les enfants de 3 à 18 ans admis en consultation et remplissant les critères d’inclusion. Résultats. Sur les 74 enfants inclus, 37 sur 51 ayant une polygraphie valide ont présenté un SAHOS, soit une fréquence hospitalière en service d’ORL de 72,5 %. Les enfants d’âge préscolaire (40,5%) et scolaire (43,2%) étaient les plus touchés avec une prédominance masculine de 54,05%. Le ronflement était le seul symptôme significativement associé au SAHOS (p=0,045). Les principales causes de SAHOS recensées étaient les hypertrophies amygdaliennes associées aux végétations adénoïdes (46%), les végétations adénoïdes simples (24,3%) et les rhinosinusites (16,2%). Conclusion. Le SAHOS est une réalité chez l’enfant au Bénin. Il doit être systématiquement recherché devant un trouble respiratoire lié au sommeil afin d’éviter à la longue des conséquences lourdes sur la croissance et le développement cognitif de l’enfant.
ABSTRACT
Introduction. Obstructive Sleep Apnea (OSA) is the most common respiratory disorder in children. The objective of this work was to determine the prevalence and factors associated with OSA in children and adolescents seen during oto-rhino-laryngology (ORL) consultations at Cotonou. Methods. This was a cross-sectional descriptive and analytical study that took place from 6 August to 30 November 2018 in the ORL departments of the teaching hospital of Suru Léré and the Avicennes medical centre in Cotonou. Recruitment was non-probabilist and involved children aged 3 to 18 years admitted to consultation and who meet the inclusion criteria. Results. Of the 74 children included, 37 of 51 with valid polygraphs had OSA, representing a 72.5% hospital frequency in ORL departement. Preschool (40.5%) and school (43.2%) children were the most affected with a male prevalence of 54.05%. Snoring was the only symptom significantly associated with OSA (p=0.045). The main causes of SAHOS identified were tonsillar hypertrophies associated with adenoids (46%), single adenoids (24.3%) and rhinosinusitis (16.2%). Conclusion. OSA is a reality in children in Benin. It should be systematically sought in children with sleep-related respiratory disorders in order to avoid serious long-term consequences on the child's growth and cognitive development.
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References
- American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.
- Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med. 1976; 27:465-84. PMID: 180875 DOI: 10.1146/annurev.me.27.020176.002341.
- Hsueh-Yu L, Li-Ang L. Sleep-disordered Breathing in Children. Chang Gung Med J. 2009; 32(3):247-57. [Internet]. 2008. Disponible sur: http://www.sfrms-sommeil.org/
- Galievsky M, Lambert A. Sleep respiratory problems in children: diagnosis and contribution of the orthodontist. International Orthodontics. 2017; 15: 405-23.
- Vergnes F. Apnées obstructives du sommeil chez l'enfant : diagnostic et prise en charge. Anesth Reanim. 2015; 1(6) : 479-86.
- Kumar H VM, Schroeder J W, Gang Z, Sheldon SH. Mallampati Score and Pediatric Obstructive Sleep Apnea. J Clin Sleep Med. 2014;10(9):985-90.
- Villa MP, Paolino MC, Castaldo R, Vanacore N, Rizzoli A, Miano S et al. Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing. Eur Respir J. 2013; 41(6): 1355-61.
- Jameleddine SBK, Ben Jemaa S, Zouari H, K. Ayed, S. Mokaddem. Prévalence des troubles du sommeil chez un groupe d’enfants tunisiens âgés de 3 à 6 ans. Médecine du sommeil. 2018 ; 15 (1):53-4. DOI: 10.1016/j.msom.2018.01.142.
- Burghard M, Krzeski A. Obstructive sleep disordered breathing in children an important problem in the light of current European guidelines. Otolaryngol Pol. 2018; 72 (5): 9-16.
- Chervin RD1, Weatherly RA, Garetz SL, Ruzicka DL, Giordani BJ, Hodges EK, Dillon JE, Guire KE. Pediatric sleep questionnaire: prediction of sleep apnea and outcomes. Arch Otolaryngol Head Neck Surg. 2007 Mar;133(3):216-22.
- Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL.A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J. 1985 Jul;32(4):429-34.
- Michael Friedman, Anna M. Salapatas, Lauren B., Bonzelaar, Updated Friedman Staging System for Obstructive Sleep Apnea. S. Karger AG, Basel Lin H-C (ed): Sleep-Related Breathing Disorders. Adv Otorhinolaryngology. 2017, 80, 41–48
- Pena-Zarza JA, Osona-Rodriguez de Torres B, Antonio Gil-Sanchez J, Figuerola-Mulet J. Utility of the Pediatric Sleep Questionnaire and Pulse Oximetry as Screening Tools in Pediatric Patients with Suspected Obstructive Sleep Apnea Syndrome. Hindawi Publishing Corporation. 2012;1-6.
- Kang KT, Weng WC, Yeh TH, Lee PL, Hsu WC. Validation of the Chinese version OSA-18 quality of life questionnaire in Taiwanese children with obstructive sleep apnea. Journal of the Formosan Medical Association. 2014 ; 11: 454-62.
- Aubertin G. Le syndrome d’apnées obstructives du sommeil chez l’enfant. Revue de Pneumologie clinique. 2013 ; 69 : 229-236
- Alonso-Álvarez ML, Navazo-Egüia AI, Cordero-Guevara JA, Ordax-Carbajo E, De La Mata G, Barba-Cermeño JL et al. Respiratory polygraphy for follow-up of obstructive sleep apnea in children. Sleep Medicine. 2012; 13 : 611-15.
- Gachelin E, Reynaud R, Dubus JC, Stremler-Le Bel N. Detection and treatment of respiratory disorders in obese children: Obstructive sleep apnea syndrome and obesity hypoventilation syndrome.Archives de Pédiatrie. 2015; 22:908-15.
- Hinkle J, Connolly HV, Adams HR, Lande MB. Severe obstructive sleep apnea in children with elevated blood pressure. Journal of the American Society of Hypertension. 2018; 12(3): 204-10.
- M.Cielo C, Silvestre J , Paliga JT, Maguire M, Gallagher PR, Marcus CL et al. Utility of screening for obstructive sleep apnea.
- Séailles T, Vecchierini MF. Les particularités des examens diagnostiques du syndrome d’apnées hypopnées obstructives du sommeil (SAHOS) de l’enfant. Rev Orthop Dento Faciale. 2015; 49: 115- 26. 51.
- Gozal D, Kheirandish-Gozal L. The obesity epidemic and disordered sleep during childhood and adolescence. Adolesc Med State Art Rev. 2010; 1: 480-90.
- Villa MP, Shafiek H, Evangelisti M, Rabasco J, Cecili M, Montesano M et al. Sleep clinical record: what differences in school and preschool children? .ERJ Open Res. 2016; 2: 00049‐2015.
- Shen L, Lin Z, Lin X, Yang Z . Risk factors associated with obstructive sleep apnea- hypopnea syndrome in Chinese children: a single center retrospective case-control study. PLoS ONE. 2018; 13(9): e0203695. Disponible: https://doi.org/10.1371/journal. pone.0203695.
- Castronovo V., Zucconi, M., Nosetti, L., Marazzini, C., Hensley, M., Veglia, F., Ferini-Strambi, L. (2003). Prevalence of habitual snoring and sleep-disordered breathing in preschool-aged children in an Italian community. The Journal of Pediatrics, 142(4), 377–382. doi:10.1067/mpd.2003.118.
- N. Maimon, Patrick J. Hanly. Does Snoring Intensity Correlate with the Severity of Obstructive Sleep Apnea?, J Clin Sleep Med. 2010 Oct 15; 6(5): 475–478. PMID: 20957849.
References
American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.
Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med. 1976; 27:465-84. PMID: 180875 DOI: 10.1146/annurev.me.27.020176.002341.
Hsueh-Yu L, Li-Ang L. Sleep-disordered Breathing in Children. Chang Gung Med J. 2009; 32(3):247-57. [Internet]. 2008. Disponible sur: http://www.sfrms-sommeil.org/
Galievsky M, Lambert A. Sleep respiratory problems in children: diagnosis and contribution of the orthodontist. International Orthodontics. 2017; 15: 405-23.
Vergnes F. Apnées obstructives du sommeil chez l'enfant : diagnostic et prise en charge. Anesth Reanim. 2015; 1(6) : 479-86.
Kumar H VM, Schroeder J W, Gang Z, Sheldon SH. Mallampati Score and Pediatric Obstructive Sleep Apnea. J Clin Sleep Med. 2014;10(9):985-90.
Villa MP, Paolino MC, Castaldo R, Vanacore N, Rizzoli A, Miano S et al. Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing. Eur Respir J. 2013; 41(6): 1355-61.
Jameleddine SBK, Ben Jemaa S, Zouari H, K. Ayed, S. Mokaddem. Prévalence des troubles du sommeil chez un groupe d’enfants tunisiens âgés de 3 à 6 ans. Médecine du sommeil. 2018 ; 15 (1):53-4. DOI: 10.1016/j.msom.2018.01.142.
Burghard M, Krzeski A. Obstructive sleep disordered breathing in children an important problem in the light of current European guidelines. Otolaryngol Pol. 2018; 72 (5): 9-16.
Chervin RD1, Weatherly RA, Garetz SL, Ruzicka DL, Giordani BJ, Hodges EK, Dillon JE, Guire KE. Pediatric sleep questionnaire: prediction of sleep apnea and outcomes. Arch Otolaryngol Head Neck Surg. 2007 Mar;133(3):216-22.
Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL.A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J. 1985 Jul;32(4):429-34.
Michael Friedman, Anna M. Salapatas, Lauren B., Bonzelaar, Updated Friedman Staging System for Obstructive Sleep Apnea. S. Karger AG, Basel Lin H-C (ed): Sleep-Related Breathing Disorders. Adv Otorhinolaryngology. 2017, 80, 41–48
Pena-Zarza JA, Osona-Rodriguez de Torres B, Antonio Gil-Sanchez J, Figuerola-Mulet J. Utility of the Pediatric Sleep Questionnaire and Pulse Oximetry as Screening Tools in Pediatric Patients with Suspected Obstructive Sleep Apnea Syndrome. Hindawi Publishing Corporation. 2012;1-6.
Kang KT, Weng WC, Yeh TH, Lee PL, Hsu WC. Validation of the Chinese version OSA-18 quality of life questionnaire in Taiwanese children with obstructive sleep apnea. Journal of the Formosan Medical Association. 2014 ; 11: 454-62.
Aubertin G. Le syndrome d’apnées obstructives du sommeil chez l’enfant. Revue de Pneumologie clinique. 2013 ; 69 : 229-236
Alonso-Álvarez ML, Navazo-Egüia AI, Cordero-Guevara JA, Ordax-Carbajo E, De La Mata G, Barba-Cermeño JL et al. Respiratory polygraphy for follow-up of obstructive sleep apnea in children. Sleep Medicine. 2012; 13 : 611-15.
Gachelin E, Reynaud R, Dubus JC, Stremler-Le Bel N. Detection and treatment of respiratory disorders in obese children: Obstructive sleep apnea syndrome and obesity hypoventilation syndrome.Archives de Pédiatrie. 2015; 22:908-15.
Hinkle J, Connolly HV, Adams HR, Lande MB. Severe obstructive sleep apnea in children with elevated blood pressure. Journal of the American Society of Hypertension. 2018; 12(3): 204-10.
M.Cielo C, Silvestre J , Paliga JT, Maguire M, Gallagher PR, Marcus CL et al. Utility of screening for obstructive sleep apnea.
Séailles T, Vecchierini MF. Les particularités des examens diagnostiques du syndrome d’apnées hypopnées obstructives du sommeil (SAHOS) de l’enfant. Rev Orthop Dento Faciale. 2015; 49: 115- 26. 51.
Gozal D, Kheirandish-Gozal L. The obesity epidemic and disordered sleep during childhood and adolescence. Adolesc Med State Art Rev. 2010; 1: 480-90.
Villa MP, Shafiek H, Evangelisti M, Rabasco J, Cecili M, Montesano M et al. Sleep clinical record: what differences in school and preschool children? .ERJ Open Res. 2016; 2: 00049‐2015.
Shen L, Lin Z, Lin X, Yang Z . Risk factors associated with obstructive sleep apnea- hypopnea syndrome in Chinese children: a single center retrospective case-control study. PLoS ONE. 2018; 13(9): e0203695. Disponible: https://doi.org/10.1371/journal. pone.0203695.
Castronovo V., Zucconi, M., Nosetti, L., Marazzini, C., Hensley, M., Veglia, F., Ferini-Strambi, L. (2003). Prevalence of habitual snoring and sleep-disordered breathing in preschool-aged children in an Italian community. The Journal of Pediatrics, 142(4), 377–382. doi:10.1067/mpd.2003.118.
N. Maimon, Patrick J. Hanly. Does Snoring Intensity Correlate with the Severity of Obstructive Sleep Apnea?, J Clin Sleep Med. 2010 Oct 15; 6(5): 475–478. PMID: 20957849.