الفهرس 
Chronic lung diseases in childrenOnly 14 pages are availabe for public view
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Abstract
Chronic chest diseases in children are chronic diseases of the airways and other parts of the lung. Some of the most common are cystic fibrosis, bronchiectasis and interstitial lung diseases. These diseases have a major impact not only on the individual with the disease, but also on the family, the community, and the health care system.
Patients with chronic chest diseases are vulnerable to sleep disorders including sleep disordered breathing in the form of sleep apnea, hypopnea, oxygen desaturation and nocturnal hypoxemia.
Sleep disordered breathing in children can cause a large array of morbidities, some of which may have long-term implications, well into adulthood. The major consequences of pediatric sleep disordered breathing involve neurobehavioral, cardiovascular, somatic growth and endocrinal and metabolic system.
Aim of the work:
We aimed to asses the prevalence of sleep disordered breathing among patients with chronic chest diseases.
Subjects and methods
We studied 25 patients (mean age 9.96 ± 3.5 years and mean body mass index 15.28±2.18); 13 patients with interstitial lung diseases, 9 with bronchiectasis and 3 with cystic fibrosis. Among the total number of the studied patients (n=25) 44% were females and 56% were males. Another group consisted of twenty-age and sex matched-clinically healthy children, were enrolled in the study as control group (mean age 10.85 ± 2.6 years and mean body mass index 16.63±4.15), 30% were females and 70% were males.
All the studied groups were subjected to overnight sleep study using non invasive apnea link (RES MED), scoring sleep disordered breathing parameters: apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI), percent flow limitation (FL %), oxygen desaturation index (ODI) and arterial oxygen saturation (SpO2).
Results:
Apnea link monitoring revealed the occurrence of sleep disordered breathing among children with chronic lung diseases defined as AHI ≥ 1events/ hour in 88% compared to 40% of control group. Abnormal apnea index (AI) was observed in 24% of patients and 5% of controls (about five-fold incidence in deseeds children).
In patients we found mean AHI = 2.81±1.4/ hour, AI = 1.66 ± 1.1events/ hour, mean ODI = 3.8 ± 2.96/ hour, mean SpO2 = 95.24 ± 3.08% and mean lowest SpO2 =84.04± 8.34 %.
In normal children we found mean AHI = 1.5±0.76 / hour, mean ODI = 1.25± 1.29 / hour, mean average SpO2 = 95.40 ± 4.24% and mean lowest SpO2 = 90.80 ± 10.24%.
Children with abnormal apnea hypopnea index had significantly lower minimum SpO2 (83.8±12% compared to 90.5±8% in normal children).
Children with interstitial lung diseases had higher, but not statistically significant, oxygen desaturation index. Also they had lower mean and lowest arterial oxygen saturation.
There was no significant correlation between pulmonary function testing and sleep disordered breathing in children with chronic lung diseases in our study.
Conclusion
Sleep disordered breathing was reported with high incidence in children with chronic lung diseases (about one fourth of them). This was manifested by abnormal apnea index (AI) and oxygen desaturation index (ODI) which were significantly higher among them compared to healthy controls.
In those patients it was found that not the apneas but the hypopneas predominate.
No certain identifiable risk factors for sleep disordered breathing in patients with chronic chest diseases was found.