Jun 30, 2015 - The incidence of sleep-disordered breathing (SDB) increases in chronic ... Related Breathing Disorder (SRBD) subscale of the Pediatric Sleep ...
Pediatric Pulmonology 51:308–315 (2016)
Sleep Disordered Breathing and Sleep Quality in Children With Bronchiolitis Obliterans Zeynep S. Uyan, MD,1* Ihsan Turan, MD,2 Pinar Ay, MD,3 Erkan Cakir, MD,4 Ersin Ozturk, MD,5 Ahmet H. Gedik, MD,4 Yasemin Gokdemir, MD,6 Ela Erdem, MD,6 Velat S S en, MD,6 Bulent Karadag, MD,6 6 Fazilet Karakoc, MD, and Refika Ersu, MD6 Summary. The incidence of sleep-disordered breathing (SDB) increases in chronic lung diseases. Our aim was to evaluate SDB and sleep quality in children with postinfectious bronchiolitis obliterans (BO) and assess associated risk factors. We hypothesized that children with BO are at increased risk for SDB and have impaired sleep quality. We also hypothesized that severity of SDB and impairment of sleep quality is related to the severity of lung disease. Sleep Related Breathing Disorder (SRBD) subscale of the Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI) questionnaires; spirometry, impulse oscillometry (IOS), and overnight polysomnography (PSG) were performed. Twenty-one patients (14 male, median age: 8.3 years) were enrolled. Five patients (25%) had a PSQ score of >0.33, predictive of a SDB. Ten patients (48%) had poor sleep quality. Four patients (19%) had an OAHI of >1/hr. Nineteen patients (90%) had a high desaturation index. Four patients (19%) had a mean oxygen saturation of 1/hr signified a positive PSG result and, hence, the diagnosis of OSAS.18 A respiratory event is scored as periodic breathing if there are 3 episodes of central apnea lasting > 3 sec separated by no more than 20 sec of normal breathing.17 A central apnea is scored in children when the event meets criteria for an apnea, there is an absence of inspiratory effort throughout the event, and at least one of the following is met: the event is 20 sec in duration, the event is associated with an arousal or 3% oxygen desaturation, (for infants under 1 year of age only) the event is associated with a decrease in heart rate to less than 50 beats per minute for at least 5 sec or less than 60 beats per minute for 15 sec.17 Blood Gas Analysis
Venous blood samples were taken at the morning after PSG for the blood gas analysis.
defined as the decrease in SpO2 by more than 4% when SpO2 was between 90% and 94% or when it decreased below 90%.20 The Borg scale was performed to assess the degree of fatigue and dyspnea just before and after the test.21 Statistical Analysis
The statistical analysis was carried out with the Statistical Package for Social Sciences (SPSS) 19.0 for Windows software program. Mean and standard deviation values were calculated for the normally distributed data while data which were not distributed normally were described as median and interquartile ranges. Continuous variables among two groups were compared with Mann– Whitney U-test when the data did not follow a normal distribution. Categorical variables were compared with chi-square and Fisher’s exact test when 20% of the expected frequencies were
