Fisiopatología de los trastornos respiratorios del sueño en los niños / Physiopathology of sleep-disordered breathing in children

Los trastornos respiratorios del sueño representan un amplio espectro de alteraciones que van desde el ronquido habitual, pasando por la hipoventilación obstructiva hasta el síndrome de apnea hipopnea del sueño (SAHS); producen anomalías de la respiración y de la arquitectura durante el sueño. Hay discrepancias entre los mecanismos fisiopatológicos de los trastornos respiratorios del sueño y sus consecuencias metabólicas, neurocognitivas y cardiovasculares. Las causas de comorbilidad del SAHS en los niños no son todavía bien conocidas y pueden incluir anomalías gasométricas sanguíneas, fragmentación del sueño, inflamación local e inflamación sistémica moduladas por factores genéticos, ambientales, raza, etc. La patogénesis de los trastornos respiratorios del sueño pediátricos es, sin lugar a dudas, una compleja interacción entre factores anatómicos o estructurales y funcionales, entre una vía aérea predispuesta al colapso y una compensación neuromuscular deficiente. Además, es necesario tener en cuenta que el sueño del niño evoluciona de acuerdo a la maduración del sistema nervioso central y ésta varía con la edad. En este artículo se revisa el papel de los diferentes factores anatómicos, funcionales e inflamatorios en la fisiopatología de los trastornos respiratorios del sueño pediátricos (AU)

Sleep-disordered breathing represents a broad spectrum of alterations, ranging from habitual snoring, through obstructive hypoventilation to obstructive sleep apnea-hypopnea syndrome, and produces breathing and architecture anomalies during sleep. There are some controversies on the physiopathological mechanisms of sleep-disordered breathing and its metabolic, neurocognitive and cardiovascular effects. The causes of comorbidity in obstructive sleep apnea-hypopnea syndrome in children are not yet well known and can include blood gasometric anomalies, fragmented sleep, and local and systemic inflammation, modulated by genetic, environmental and ethnic factors. The pathogenesis of pediatric sleep-disordered breathing undoubtedly involves complex interactions between anatomical or structural and functional factors, an airway prone to collapse and deficient neuromuscular compensation. Moreover, in children, sleep progresses in accordance with central nervous system development, which varies with age. This article reviews the role of the distinct anatomic, functional and inflammatory factors in the pathophysiology of pediatric sleep-disordered breathing (AU)

[Obstructive sleep apnoea syndrome in children]. / Síndrome de apnea obstructiva en niños.

Obstructive sleep apnoea syndrome is a well-known clinical entity in adults but until now it has been less well studied in children. In recent years there has been a dramatic increase in the recognition of sleep disorders in children. Our goal is to analyze scientific data published in the last few years. We reviewed published articles regarding paediatric obstructive sleep apnoea syndrome and extracted the clinical symptoms, diagnosis and treatment options. In conclusion, the natural course and long-term prognosis of childhood obstructive sleep apnoea syndrome are not well-known and further studies are needed in this area.

Síndrome de apnea obstructiva en niños / Obstructive sleep apnoea syndrome in children

El síndrome de apnea obstructiva del sueño es una entidad bien conocida en adultos, pero hasta ahora ha sido menos estudiada en niños. Recientemente se ha producido un importante incremento en el reconocimiento de los trastornos del sueño en la etapa infantil. Nuestro objetivo es analizar los estudios científicos publicados en los últimos años. Hemos revisado artículos publicados acerca del síndrome de apnea obstructiva en edad pediátrica y hemos estudiado la sintomatología, el diagnóstico y las opciones de tratamiento. En conclusión, el curso natural y el pronóstico a largo plazo del síndrome de apnea obstructiva en la infancia no son bien conocidos, por lo que se necesitan más estudios en esta área (AU)

Obstructive sleep apnoea syndrome is a well-known clinical entity in adults but until now it has been less well studied in children. In recent years there has been a dramatic increase in the recognition of sleep disorders in children. Our goal is to analyze scientific data published in the last few years. We reviewed published articles regarding paediatric obstructive sleep apnea syndrome and extracted the clinical symptoms, diagnosis and treatment options. In conclusion, the natural course and long-term prognosis of childhood obstructive sleep apnoea syndrome are not well-known and further studies are needed in this area (AU)

[Some differential considerations of OSAS in adults and children]. / Algunas consideraciones diferenciales del SAOS en adultos y niños.

Some respiratory troubles on childhood keep, comparatively with the same adult's pathology, certain peculiarities worth to know. This is the case of obstructive sleep apnea syndrome, which can suffer both children and adults, but with important etiopathogenical differences: clinical, and therapeutical between the two ages groups, which we must have in mind. Report of differential considerations between the 2 age-groups that we consider more relevants in this syndrome, that every time is more and more seen in clinical practice.