Faktor Risiko Obstructive Sleep Apnea pada Anak Sindrom Down​

Dewi Kartika Suryani, Bambang Supriyatno, Mulya Rahma Karyanti, Zakiudin Munasir, Sudung O. Pardede, Dina Muktiarti

Sari


Latar belakang. Sindrom Down merupakan kelainan kromosom tersering. Anak dengan sindrom Down (SD) di berbagai negara memiliki beberapa faktor risiko terhadap OSA dengan prevalensii antara 30%-60%, dibandingkan 0,7%-2% pada populasi umum. Hingga saat ini belum ada data mengenai OSA pada anak sindrom Down di Indonesia.
Tujuan. Mengidentifikasi prevalensi OSA pada anak sindrom Down dan menganalisis hubungan antara habitual snoring, obesitas, penyakit alergi di saluran napas, hipertrofi tonsil, dan hipertrofi adenoid sebagai faktor risiko OSA pada anak sindrom Down.
Metode. Penelitian potong lintang dilakukan pada anak sindrom Down berusia 3-18 tahun yang tergabung dalam Yayasan POTADS. Penelitian dilakukan di Poliklinik Respirologi IKA FKUI RSCM dari bulan Juli 2016 hingga Juli 2017. Penegakan diagnosis OSA menggunakan nilai batas AHI≥3 pada pemeriksaan poligrafi. Faktor- risiko yang dianggap berpengaruh dianalisis secara multivariat.
Hasil. Penelitian dilakukan terhadap 42 subjek dengan hasil prevalensi OSA pada anak dengan SD 61,9%. Sebesar 42,9% merupakan OSA derajat ringan, 14,3% OSA sedang, dan 4,8% OSA berat. Pada analisis multivariat didapatkan faktor risiko yang bermakna yaitu habitual snoring (p=0,022 dan PR 8,85; IK 1,37-57) dan hipertrofi adenoid (p=0,006 dan PR 12,93; IK 2,09-79).
Kesimpulan. Prevalensi OSA pada anak sindrom Down sebesar 61,9%. Faktor risiko yang bermakna yaitu habitual snoring dan hipertrofi adenoid.


Kata Kunci


OSA; sindrom Down; faktor risiko

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Referensi


Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, dkk. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012;130:57

Chhangani BS, Melgar T, Patel D. Pediatric obstructive sleep apnea. Indian J Pediatr 2010;77:81-5.

Bhatt SP, Guleria R, Kabra SK. Obstructive sleep apnea syndromes in children. Int J Med Med Sci 2014;1:14-20.

Supriyatno B, Deviani R. Obstructive sleep apnea syndrome pada anak. Sari Pediatri 2005;7:77-84.

Chng SY, Goh DYT, Wang XS, Tan TN, Ong NB. Snoring and atopic disease: a strong association. Pediatr Pulmonol 2004;38:210-16.

Mai CT, Kucik JE, Isenburg J, Feldkamp ML, Marengo LK, Bugenske EM, dkk. National birth defect prevention N. Selected birth defects data from population-based birth defects surveillance program in the United States, 2006 to 2010: featuring trismoy conditions. Birth Defects Res A Clin Mol Teratol 2013;97:709-25.

Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia (RI). Riset kesehatan dasar (RISKESDAS) 2013. Jakarta: Kementerian Kesehatan RI; 2013.

Chan J, Edman JC, Koltai PJ.Obstructive sleep apnea in children. Am Fam Physician 2004;69:1147-54.

Bull MJ. The Committee on Genetics. Health supervision for children with Down syndrome. Pediatrics 2011;128:393-406.

Chin CJ, Khami MM, Husein M.A general review of the otolaryngologic manifestation of Down syndrome. Int J Pediatr Otorhinolaryngol 2014;78:899-904.

Shott S, Amin R, Chini B, Heubi C, Hotze S, Akers R. Obstructive sleep apnea: should all children with Down syndrome be tested? Arch Otolaryngol Head Neck Surg 2006;132: 432-6.

Shoot SR. Down syndrome : common otolaryngologic manifestation. Am J Med Genet C Semin Med Genet 2006;142:131-40.

Lal C, White DR, Joseph JE, Bakergem K, LaROsa A. Sleep-disordered breathing in Down syndrome. Chest 2015;147:570-9.

Beck S, Marcus CL. Pediatric polisomnography. Sleep Med Clin 2009;4:393-406.

Capdevila OS, Kheirandish-Gozal L, Dayyat E, Gozal D. Pediatric obstructive sleep apnea: complication, management, and long term outcome. Proc Am Thorac Soc 2008;5:274-82.

Breslin J, Spano G, Bootzin R, Anand P, Nadel L, Edgin J. Obstructive sleep apnea syndrome and cognition in Down syndrome. Dev Med Child Neurol 2014;56:657-64.

Baumer N, Davidson EJ. Supporting a happy, healthy adolescence for young people with Down syndrome and other intellectual disabilities: recommendation for clinicians. Curr Opin Pediatr 2014;26:428-34.

Muzumdar H, Arens R. Diagnostic issues in pediatric obstructive sleep apnea. Proc Am Thorac Soc 2008;5:263-73.

Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc 2008;5:242-52.

Miguel-Diez J, Villa-Asensi JR, Ivarez-Sala AJL. Prevalence of sleep-disordered breathing in children with Down syndrome: polygrapic findings in 108 children. Sleep 2003;26:1006-9.

Dyken ME, Lin-Dyken DC, Poulton S, Bridget Z, Sedars E. Prospective polysomnographic analysis of obstructive sleep apnea in Down syndrome. Arch Pediatr Adolesc Med 2003;157:655-60.

Fitzgerald DA, Paul A, Richmond C. Severity of obstructive apnoea in children with Down syndrome who snore. Arch Dis Child 2007;92:423-5.

Ng DK, Hui HN, Chan Ch, Kwok LL, Chow PY, Cheung JM, dkk. Obstructive sleep apnea in children with Down syndrome. Singapore Med J 2006;47:774-9.

Austeng ME, Overland B, Kvaerner KJ, Anderson EM, Axelsson S, Abdelnoor M, dkk. Obstructive sleep apnea in younger school children with Down syndrome. J Pediatr Otorhinolaryngol 2014;1:1-4.

Maris M, Verhulst S, Wojciechowski M, Heyning PV, Boudewyns A. Prevalence of obstructive sleep apnea in children with Down syndrome. Sleep 2016;39:699-704.

Lin SC, Davey MJ. Horne RS. Nixon GM. Screening for obstructive sleep apnea in children with Down syndrome. J Pediatr 2014;165:117-22.

Hwang SH, Guilleminault C, Park CS, Kim TW, Hong SC. Usefullness of adenotonsilar size for prediction of severity of obstructive sleep apnea and flow limitatation. Otolaryngology Head and Neck Surg 2013;149:327-34.

Ronen O, Malhotra A, Pillar G. Influence of gender and age on upper-airway length during development. Pediatrics 2007;120:1028-34.

Katz ES, Ambrosia CM. Pathophysiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc 2008;5:253 62.

Shires CB, Anold SL, Schoumacher RA, Dehoff GW, Donepudi SK, Stocks RM. Body mass index as an indicator of obstructive sleep apnea in pediatric Down syndrome. Int J Pediatr Otorhinolaryngol 2010;74:768-72.

Basil SJ, Santoro SL, Martin LJ, Healy KW, Chini BA, Saal HM. Retrospective study of obesity in children with Down syndrome. J Pediatr 2016;173:143-8.

Bassel JL. Sleep profiles in children with Down syndrome. Am

J Med Genet A 2015;167:1830-5.

Supriyatno B, Deviani R, Tumbelaka A, Kariani EBK, Rahajoe

NN. . Characteristics and risk factors of snoring and the prevalence of suspected obstructive sleep apnea in children. Pediatr Indones 2005;45:40-5.

Lopez FM. Pediatrics, Down’s syndrome and allergic disease. Rev Med Int Sindr Down 2011:15:8-13.

Mannan SE. Yousef E. Hossain J. Prevalence of positive skin prick test result in children with Down syndrome : a casecontrol study. Ann Allergy Asthma Immunol 2009;102:205-9.

Kara CO, Ergin H, Kocak G, Kilic I, Yurdakul M. Prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children in Denizli, Turkey. Int J Pediatr Otorhinolaryngol 2002;66:175-9.

Kang KT, Chou CH, Weng WC, Lee PL, Hsu WC. Associations between adenotonsilar hypertrophy, age, and obesity in children with obstructive sleep apnea. PlosOne 2013;8:1-8.

Evcimik MF, Dogru M, Cirik AA, Nepesov MI. Adenoid hypertrophy in children with allergic disease and influential factor. Int J Pediatr Otorhinolaryngol 2015;79:694-7.

Tagaya M, Nakata S, Yasuma F, Miyazaki S, Sasaki F, Morigana

M, dkk. 2012 Relationship between adenoid size and severity of obstructive sleep apnea in preschool children. Int J Pediatr Otorhinolaryngol 2012;76:1827-30.

Somayaji K.S. Rajeshwari A, Mahaveera J. Significance of adenoid nasopharyngeal ratio in the assessment of adenoid hypertrophy in children. Res Otolaryngol 2012;1:1-5.




DOI: http://dx.doi.org/10.14238/sp20.5.2019.295-302

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