Hábitos de sono e autoavaliação miofuncional orofacial de crianças com risco para distúrbios respiratórios do sono / Sleep habits and orofacial myofunctional self-assessment of children at risk for sleep breathing disorders

RESUMO Objetivo Identificar e correlacionar as queixas de alterações miofuncionais orofaciais e de risco para distúrbios respiratórios do sono com hábitos de sono na infância. Método Participaram 71 pais ou responsáveis de crianças de 6 a 11 anos, matriculadas em uma escola pública. Foi aplicado um formulário com questões semiestruturadas/anamnese e os protocolos Nordic Orofacial Test-Screening - entrevista, Pediatric Obstructive Sleep Apnea Screening Tool Questionnaire, e Children's Sleep Habits Questionnaire - todos em suas versões em português/Brasil no formato online. Para a análise estatística, realizou-se o teste de correlação de Spearman, considerando o nível de significância de 5%. Resultados 29 crianças eram do sexo feminino (40,8%) e 42 do sexo masculino (59,2%), com média de idade de 8,52 anos. As queixas miofuncionais orofaciais encontradas foram relacionadas às funções de respiração (35,2%), mastigação e deglutição (32,4%) e hábitos deletérios (33,8%). Todas as crianças apresentaram um baixo risco para distúrbios respiratórios do sono e quanto aos hábitos de sono, 23 crianças (32,39%) apresentaram uma somatória menor, enquanto que 48 crianças (67,61%) ultrapassaram 41 pontos. Conclusão Houve correlação entre risco para distúrbios respiratórios do sono em crianças com as queixas de alterações miofuncionais orofaciais e com a baixa qualidade/maus hábitos de sono.

ABSTRACT Purpose To identify orofacial myofunctional complaints and sleep-disordered breathing and correlate them with sleep habits in childhood. Methods The study included 71 parents/guardians of public school children aged 6 to 11 years. They answered a form with semi-structured medical history questions and the Nordic Orofacial Test-Screening - interview, the Pediatric Obstructive Sleep Apnea Screening Tool Questionnaire, and the Children's Sleep Habits Questionnaire - all of them in their Portuguese/Brazilian versions in an online format. Statistical analyses used Spearman's correlation, setting the significance level at 5%. Results There were 29 female children (40.8%) and 42 male ones (59.2%), with a mean age of 8.52 years. The study found orofacial myofunctional complaints related to breathing functions (35.2%), chewing and swallowing (32.4%), and deleterious habits (33.8%). All children were at a low risk of sleep-disordered breathing. As for sleep habits, 23 children (32.39%) had a lower total score, whereas 48 children (67.61%) exceeded 41 points. Conclusion There was a correlation between the risk of sleep-disordered breathing in children with complaints of orofacial myofunctional disorders and poor sleep quality/habits.

Sleep habits and orofacial myofunctional self-assessment of children at risk for sleep breathing disorders. / Hábitos de sono e autoavaliação miofuncional orofacial de crianças com risco para distúrbios respiratórios do sono.

PURPOSE: To identify orofacial myofunctional complaints and sleep-disordered breathing and correlate them with sleep habits in childhood. METHODS: The study included 71 parents/guardians of public school children aged 6 to 11 years. They answered a form with semi-structured medical history questions and the Nordic Orofacial Test-Screening - interview, the Pediatric Obstructive Sleep Apnea Screening Tool Questionnaire, and the Children's Sleep Habits Questionnaire - all of them in their Portuguese/Brazilian versions in an online format. Statistical analyses used Spearman's correlation, setting the significance level at 5%. RESULTS: There were 29 female children (40.8%) and 42 male ones (59.2%), with a mean age of 8.52 years. The study found orofacial myofunctional complaints related to breathing functions (35.2%), chewing and swallowing (32.4%), and deleterious habits (33.8%). All children were at a low risk of sleep-disordered breathing. As for sleep habits, 23 children (32.39%) had a lower total score, whereas 48 children (67.61%) exceeded 41 points. CONCLUSION: There was a correlation between the risk of sleep-disordered breathing in children with complaints of orofacial myofunctional disorders and poor sleep quality/habits.

OBJETIVO: Identificar e correlacionar as queixas de alterações miofuncionais orofaciais e de risco para distúrbios respiratórios do sono com hábitos de sono na infância. MÉTODO: Participaram 71 pais ou responsáveis de crianças de 6 a 11 anos, matriculadas em uma escola pública. Foi aplicado um formulário com questões semiestruturadas/anamnese e os protocolos Nordic Orofacial Test-Screening - entrevista, Pediatric Obstructive Sleep Apnea Screening Tool Questionnaire, e Children's Sleep Habits Questionnaire - todos em suas versões em português/Brasil no formato online. Para a análise estatística, realizou-se o teste de correlação de Spearman, considerando o nível de significância de 5%. RESULTADOS: 29 crianças eram do sexo feminino (40,8%) e 42 do sexo masculino (59,2%), com média de idade de 8,52 anos. As queixas miofuncionais orofaciais encontradas foram relacionadas às funções de respiração (35,2%), mastigação e deglutição (32,4%) e hábitos deletérios (33,8%). Todas as crianças apresentaram um baixo risco para distúrbios respiratórios do sono e quanto aos hábitos de sono, 23 crianças (32,39%) apresentaram uma somatória menor, enquanto que 48 crianças (67,61%) ultrapassaram 41 pontos. CONCLUSÃO: Houve correlação entre risco para distúrbios respiratórios do sono em crianças com as queixas de alterações miofuncionais orofaciais e com a baixa qualidade/maus hábitos de sono.

Assessment of websites on cleft lip and palate in Brazilian Portuguese

ABSTRACT Purpose: this study aimed at assessing the legibility, reliability, usability and coverage of websites on cleft lip and/or palate (CL/P) in Brazilian Portuguese and providing a global comparison. Methods: in order to evaluate the obtained data, four protocols were used, i.e., the Website Coverage Protocol, the legibility (by means of the COH METRIX PORT), the reliability (Discern Protocol), and the usability (by means of the System Usability Scale). Results: 98 websites were included with average legibility scoring of 31.6±11.7, rated as a hard readability level. Coverage average scoring was 19.9±3.79 from a total of 35 points. As for reliability, average scoring was 43.2±6.51 points, rated as acceptable. The usability scoring was 24.8±2.18 points, rated as the worst imaginable one. Conclusion: therefore, the assessed Brazilian websites on CL/P were rated difficult for legibility, requiring high-school level of education, restricted coverage and acceptable reliability, in addition to the low usability. The results were similar to those of websites from other countries, except for the legibility aspect, which was lower for Brazilian websites.

Unsupervised type III polygraphy in children undergoing adenotonsillectomy: a technical and economic report.

OBJECTIVE: To evaluate the economic and technical viability of the sleep study (type III) in children with adenotonsilar hypertrophy. METHODS: 141 children were submitted to sleep study (type III), aged between three and 11, all with symptoms of OSA. The frequency of failed examinations and a comparison of cost analysis between complete polysomnography were described. RESULTS: 41 exams lost at least one sensor. The sensor with the highest number of losses was the oximetry, observed in 14.28%. The 100 valid sleep studies allowed the diagnosis of severe OSA in 36 children. Sleep study accounts for approximately 63% of the value of the PSG type I, thus, it showed to be cost effective even with the repetition of the failed one. CONCLUSION: Sleep study (type III) may have high failure rates and it was a reliable exam for the identification of severe OSA. The cost analysis showed economic feasibility, even with a high failure rate and necessity of repetition.

The short evaluation of orofacial myofunctional protocol (ShOM) and the sleep clinical record in pediatric obstructive sleep apnea.

INTRODUCTION: Multiple anatomic and functional risk factors contribute to Obstructive Sleep Apnea (OSA) in children, most of the screening tools only evaluate clinical symptoms. The aim was to describe the evaluation of the short orofacial myofunctional protocol (ShOM) in OSA children, and to analyze if the inclusion of orofacial myofunctional aspects would influence the screening sensitivity/specificity of the Sleep Clinical Record (SCR). METHODS: Children from Brazil and Italy with sleep disordered breathing were evaluated by full night polygraphy, the SCR and the ShOM. For the analysis of the correlations, we normalized the distribution of the children based on the percentiles of the Apnea and Hypopnea Index (AHI). The children were divided in: Group1: first percentile AHI up to25% (cut-off value: AHI≤1.9); Group 2: second percentile from 25% to 75% (cut-off values: 1.9˂AHI≤7.9); Group3: third percentile AHI˃75% (cut = off value: AHI˃7.9). The findings of SCR and ShOM were compared for each group. ROC curve of the sensitivity and specificity of OSA diagnosis were compared for SCR alone and the combined results of SCR plus ShOM. RESULTS: 86 children, 47 girls, 4-11 years, were included, 34 children were obese and 20 overweight. OSA severity and obesity showed a positive correlation (p = 0.04). Mean ShOM score was 5.64 ± 2.27, with a positive correlation to the SCR (p = 0.002). In Group1, the SCR showed more nasal obstruction, arched palate and OSAS score/positive Brouilette questionnaire and the ShOM scored more alterations to breathing mode, breathing type (p = 0.01) and lip competence. In Group 3, we found more tonsillar hypertrophy, Friedman tongue position alteration (p < 0.001), malocclusion and obesity at SCR and more alterations in tongue resting position, tongue deglutition position and malocclusion at ShOM. CONCLUSIONS: The myofuntional evaluation contributed to the screening of OSA in children, while alterations of the tongue (resting and deglutition position) were observed in children with the highest AHI percentile. The combination of SCR and ShOM improved the sensitivity and specificity for the identification of pediatric OSA when compared to SCR alone.

Website Babies Portal: development and evaluation of the contents regarding orofacial functions

Education mediated by technology facilitates the access to information and can reach more people, including a broader range of socio-economic groups and ages, and at a low-cost. The website "Babies Portal - Speech-Language Pathology/Audiology and Dentistry" (http://portaldosbebes.fob.usp.br) was developed to provide parents with information on communication procedure disorders and oral health, enabling them to prevent and identify any changes in development early while looking for the best treatment. Objective: The objective is to describe the development and evaluation of the content pertaining to the oral functions featured in the "Babies Portal". Methods: The first stage consisted of a literature review, development/selection of illustrations and an evaluation of the possible external links that could be available. In the second stage, 10 speech-language and hearing pathologists (group A) and five parents of babies (group B) evaluated the website via an online form, which included ethical and personal information and questions about the quality, technical information and comparative prior knowledge acquired after the access. In the first stage, there was the construction of five sections ("The Oral Functions", "Breastfeeding", "Food", "Pacifier, baby bottle and finger sucking" and "Breath") based on scientific studies, presenting objective information, content links prepared by the Ministry of Health and a Dentistry section in the "Babies Portal" website. Videos, static and dynamic images were also distributed throughout the sections. Results: Regarding the second stage, 90% of all speech-language and hearing pathologists judged a good/excellent quality for all sections and classified the technical quality as very good. By their turn, 88% of the parents (group B) reported that the website helped or helped very much in understanding the contents, and 80% rated the quality as good or excellent. Conclusions: Five sections concerning ...

Website Babies Portal: development and evaluation of the contents regarding orofacial functions.

UNLABELLED: Education mediated by technology facilitates the access to information and can reach more people, including a broader range of socio-economic groups and ages, and at a low-cost. The website "Babies Portal - Speech-Language Pathology/Audiology and Dentistry" (http://portaldosbebes.fob.usp.br) was developed to provide parents with information on communication procedure disorders and oral health, enabling them to prevent and identify any changes in development early while looking for the best treatment. OBJECTIVE: The objective is to describe the development and evaluation of the content pertaining to the oral functions featured in the "Babies Portal". METHODS: The first stage consisted of a literature review, development/selection of illustrations and an evaluation of the possible external links that could be available. In the second stage, 10 speech-language and hearing pathologists (group A) and five parents of babies (group B) evaluated the website via an online form, which included ethical and personal information and questions about the quality, technical information and comparative prior knowledge acquired after the access. In the first stage, there was the construction of five sections ("The Oral Functions", "Breastfeeding", "Food", "Pacifier, baby bottle and finger sucking" and "Breath") based on scientific studies, presenting objective information, content links prepared by the Ministry of Health and a Dentistry section in the "Babies Portal" website. Videos, static and dynamic images were also distributed throughout the sections. RESULTS: Regarding the second stage, 90% of all speech-language and hearing pathologists judged a good/excellent quality for all sections and classified the technical quality as very good. By their turn, 88% of the parents (group B) reported that the website helped or helped very much in understanding the contents, and 80% rated the quality as good or excellent. CONCLUSIONS: Five sections concerning the oral functions were structured, and the results collected from groups A and B suggest that the content provided is adequate and reliable.