Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- noisy breathing during sleep
- apneas
- choking or gasping
Outros fatores diagnósticos
- waking up tired
- daytime somnolence
- hyperactivity
- behavioral problems
- night terrors
- enuresis
Fatores de risco
- increasing age
- male sex
- obesity (BMI >30)
- craniofacial abnormalities
- endocrine disorders
- neck circumference over 40 cm
- sedating medications
- adenotonsillar hypertrophy
- long soft palate and uvula
- alcohol consumption
- Down syndrome
- gastroesophageal reflux
- active or passive smoking
- abnormal epiglottis
- hypopharyngeal cysts or tumors
- rhinitis/nasal obstruction
- asthma
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- nasal decongestant test
- Epworth sleepiness score (ESS)
Investigações a serem consideradas
- snoring scale score
- TFTs
- growth hormone level
- skin-prick tests/serum allergen-specific IgE tests
- sleep study
- acoustic analysis
- pharyngeal manometry
- sleep nasendoscopy
Novos exames
- head and neck 3-dimensional CT
- head and neck MRI
Algoritmo de tratamento
adult: without UARS or OSA
adult: with UARS or OSA
child: without concurrent indication for tonsillectomy or adenoidectomy
child: with concurrent indication for tonsillectomy or adenoidectomy
child: with UARS or OSA
Colaboradores
Autores
Nadia Ashraf, BMBS, BMedSci(Hon), DA, DOHNS, FRCS(ORL-HNS)
Specialty Registrar in Otorhinolaryngology-Head & Neck Surgery
Sheffield Teaching Hospitals NHS Trust
Sheffield
UK
Declarações
NA declares that she has no competing interests.
Showkat Mirza, BM, BS, BMedSci, FRCS(ORL-HNS)
Consultant in Otorhinolaryngology-Head & Neck Surgery
Sheffield Teaching Hospitals NHS Trust
Sheffield
UK
Declarações
SM declares that he has no competing interests.
Revisores
Jayant Pinto, MD
Assistant Professor of Surgery
Section of Otolaryngology-Head and Neck Surgery
University of Chicago
Chicago
IL
Declarações
JP declares that he has no competing interests.
Michael J. Hensley, MBBS, PhD, FRACP
Director
Department of Respiratory and Sleep Medicine
John Hunter Hospital
Professor and Head
School of Medicine and Public Health
Faculty of Health
The University of Newcastle
NSW
Australia
Declarações
MJH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Savage CR, Steward DL. Snoring: a critical analysis of current treatment modalities. Does anything really work? Curr Opinion Otolaryngol Head Neck Surg. 2007 Jun;15(3):177-9. Resumo
Kubba H. A child who snores. Clin Otolaryngol. 2006 Aug;31(4):317-8. Resumo
Fairbanks DNF, Mickelson SA, Woodson BT, eds. Snoring and obstructive sleep apnea. 3rd ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2003.
Friedman M. Prognostic indicators for successful uvulopalatopharyngoplasty. Sleep. 2000;23:A268.
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Upper airway resistance syndrome (UARS)
- Obstructive sleep apnea (OSA)
- Stridor
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