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SLEEP-DISORDERED BREATHING IN CHILDREN WITH PERIODIC LIMB MOVEMENT: THE ROLE OF RAPID MAXILLARY EXPANSION
Introduction: Pediatric restless legs syndrome (RLS) in children has an estimated prevalence of 2%. RLS affects the quality of life, sleep, cognition, and behavior in children and adults. The supportive criteria of a family history of RLS and periodic limb movements in sleep (PLMs) >5 per hour are predictive of pediatric RLS.
To evaluate the short-term efficacy of rapid maxillary expansion (RME) on PLMS in children with sleep-disordered breathing (SDB) after delayed adenotonsillectomy (AT).
Method: Prospective clinical trial study using RME therapy. The inclusion criteria of participants were: children aged 5 to 12 years, who had AT more than two years ago, whose parents/guardians reported that they still snore ≥4 nights per week, with maxillary transverse deficiency and the PLMS > 5 per hour. Thirteen children with primary snoring and 11 with obstructive sleep apnea participated in this study. Patients underwent Nasopharyngoscopy, Polysomnography and Quality of Life Questionnaire (OSA-18) before and after six months of RME.
OSA-18 domain total scores reduced significantly in both groups (p < 0.001). There was a reduction in snoring after RME in both groups, but more significant in the OSA group. There was a decrease in periodic limb movements (PLMs). There was a decrease in the periodic movements of PLMs. 30.8% of primary snoring children had PLMS > 5/hour and decreased post-RME to 7.7%. While the AOS children changed from 36.4% to 9,1% post-RME.I In the total sample, the mean PLMS decreased significantly from 4.2/h to 1.1/h/h after RME treatment.
RME may be an alternative treatment that improves symptoms and quality of life in children with SRD. The improvement of the SDB with RME had a positiveimpact on PLMs as well.
periodic limb movements of sleep; polysomnography; restless legs syndrome, Sleep Apnea Obstructive, Snoring
Rita Catia Bariani, Renato Bigliazzi, Thais Moura Guimarâes, katia Regina Prade, Camila Baruqui Guillen, Sergio Tufik, Gustavo Antonio Moreira, Reginaldo Raimundo Fujita