Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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소아의 폐쇄성 수면무호흡 증후군과 일차성 코골이의 감별 임상양상 및 행동장애 비교

Discrimination between obstructive sleep apnea syndrome and primary snoring in children : comparison of clinical parameters and behavioral disturbance

  • 서현주 (을지대학교 의과대학 을지병원 소아과학교실) ;
  • 이재숙 (을지대학교 의과대학 을지병원 소아과학교실) ;
  • 신홍범 (을지대학교 의과대학 을지병원 신경정신과) ;
  • 김의중 (을지대학교 의과대학 을지병원 신경정신과) ;
  • 심현준 (을지대학교 의과대학 을지병원 이비인후과) ;
  • 안영민 (을지대학교 의과대학 을지병원 소아과학교실)
  • Seo, Hyun-Joo (Department of Pediatrics, Eulji University School of Medicine) ;
  • Lee, Jae Suk (Department of Pediatrics, Eulji University School of Medicine) ;
  • Shin, Hong-Beom (Department of Psychiatry, Eulji University School of Medicine) ;
  • Kim, Eui-Joong (Department of Psychiatry, Eulji University School of Medicine) ;
  • Shim, Hyun-Joon (Department of Otolaryngology, Eulji University School of Medicine) ;
  • Ahn, Young-Min (Department of Pediatrics, Eulji University School of Medicine)
  • 투고 : 2007.08.13
  • 심사 : 2007.09.13
  • 발행 : 2008.03.15
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초록

목 적 : 신체검진 결과와 증상점수를 통하여 폐쇄성 수면무호흡증과 일차성 코골이를 감별할 수 있는가를 평가하고자 하였다. 방 법 : 56명의 코골이 환아와 20명의 무증상 대조군에게 수면다원검사를 시행하여 39명의 패쇄성 수면무호흡증후군 환아와 17명의 일차성 코골이 환아, 20명의 대조군으로 나누었다. 이들을 대상으로 편도-아데노이드의 크기를 측정하였고 수면호흡장애를 평가하는 SDBS과 OSA-18를, 그리고 행동장애를 평가하는 설문인 ADHD RS-IV을 조사하였다. 결 과 : 폐쇄성 수면무호흡증군과 일차성 코골이군의 아데노이드와 편도의 크기, SDBS ($9.4{\pm}4.6\;vs\;10.8{\pm}4.5$), OSA-18 score ($61.1{\pm}25.1\;vs\;71.2{\pm}8.4$)를 비교한 결과 통계적으로 유의한 차이를 보이지 않았으나 대조군과의 비교에서는 두군 모두 통계적으로 유의하게 높았다. ADHD RS-IV의 평균점수도 두군 모두 대조군($2.9{\pm}3.3$)보다 유의하게 높았으나 폐쇄성 수면무호흡증군($15.8{\pm}7.9$)과 일차성 코골이군($22.2{\pm}9.4$) 두군간의 비교에서는 차이를 보이지 않았다. 결 론 : 코골이 환아에서 편도 아데노이드의 크기와 증상 점수로는 폐쇄성 수면무호흡증군과 일차성 코골이군을 감별할 수 없었다. 또한 주의력 결핍 과잉행동 장애 증상 점수가 일차성 코골이 환아에서도 폐쇄성 수면무호흡증군과 같이 정상대조군에 비해 높은 결과를 보였다.

Purpose : To determine whether primary snoring could be distinguished from obstructive sleep apnea syndrome (OSAS) by clinical evaluation and symptom scores. Methods : 56 snoring and 20 asymptomatic subjects were recruited and polysomnography was used to confirm that there were 39 OSAS, 17 primary snoring, and 20 control subjects. We evaluated the size of the childrens adenoids and tonsils. Parents completed sleep disordered breathing scale (SDBS) and obstructive sleep apnea 18 (OSA-18) questionnaires for use as symptom scores, as well as an attention deficit hyperactivity disorder rating scale-IV (ADHD RS-IV). Results : There were no differences between primary snoring and OSAS in terms of tonsil and adenoid size, SDBS ($9.4{\pm}4.6\;vs\;10.8{\pm}4.5$), and OSA-18 score ($61.1{\pm}25.1\;vs\;71.2{\pm}8.4$). The patients with OSAS ($15.8{\pm}7.9$) and PS ($22.2{\pm}9.4$) had a higher ADHD RS-IV score than the control subjects ($2.9{\pm}3.3$). There was no difference in the ADHD RS-IV scores of patients with primary snoring and OSAS. Conclusion : We confirmed that clinical evaluation could not distinguish OSAS and primary snoring. In addition, our study suggests that primary snoring as well as OSAS is associated with attention deficit hyperactivity disorder.

키워드

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