Distúrbio de hiperatividade e déficit de atenção na síndrome de apnéia obstrutuiva do sono: há melhora com tratamento cirúrgico?

Abstract

Neuropsychol ogical disorders are frequently associated with obstructive ventilatory disorders (OVD). Aim: To analyze the incidence of neuropsychological disorders in Brazilian children with OVD, using a screening questionnaire and to compare the answers given before and after surgery. Patients and Methods: We studied 30 children with clinical diagnosis of OVD. The children were divided into 3 groups: group I, children aged 4 to 7; group II, from 8 to 10; and group III, children over 11. The applied questionnaires were answered by the parents or tutors, and comprised 30 questions, 10 for each disorder: attention deficit, hyperactivity and impulsivity. The children were diagnosed with one of the disorders when presented 3 or more positive answers. The follow up interview occurred 6 months after adenotonsillectomy. Results: There was a predominance of male gender (60.6%) over female gender (39.4%). Group II presented the highest number of significant changes, with reductions raging from 87.5% to 33.3% of patients with attention deficit, 75% to 50% of the hyperactive patients, and 50% to 33% of the impulsive patients. Conclusion: There was neuropsychological improvement after the surgery, which occurred mainly in the children from group II. More interaction among health professionals is necessary when diagnosing and following up similar cases.

Alterações orofaciais em doenças alérgicas de vias aéreas

“…A qualidade do sono e a da respiração, portanto, estão associadas. Tal fato explica a relação das alterações no sono com as dificuldades de atenção e concentração necessárias para a aprendizagem (17) e indica que crianças respiradoras orais apresentam maior risco de desenvolver dificuldade de aprendizagem (44) e transtornos de déficit de atenção/hiperatividade (38,45) .…”

Health Promotion in Obstructive Sleep Apnea Syndrome

“…Besides the OSAS effect during sleep (i.e., intermittent hypoxemia, transient hypercapnia, and frequent waking), 16 other implications such as attention deficit in the learning process and in auditory memory and alteration of the tonicity of orofacial myofunctional muscles may be observed. 17 18 19 20 It is worth mentioning the consequences affecting the population, such as decreased job productivity and increased work and traffic accidents. 21 22 23 …”

Echocardiographic abnormalities in children with obstructive breathing disorders during sleep

“…Os sintomas referidos mais freqüentes são: roncos, pausas respiratórias, dificuldade para respirar, sono agitado e sudorese noturna 2,6 . A SAHOS pode ter conseqüên-cias clínicas graves, como cor pulmonale [7][8][9] , além de impacto negativo na qualidade de vida da criança, como atraso no crescimento pôndero-estatural, alterações do esqueleto facial e torácico 10 , enurese noturna e distúrbios do comportamento, do aprendizado e de outras funções cognitivas 11 .…”