ผลการฝึกกล้ามเนื้อหายใจเข้าที่บ้านต่อสมรรถภาพปอดและการทำงานของกล้ามเนื้อหายใจในเด็กและวัยรุ่นที่มีภาวะหยุดหายใจขณะนอนหลับ เนื่องจากทางเดินหายใจอุดกั้นและอ้วน: รายงานผู้ป่วย

Abstract

Obstructive sleep apnea (OSA) which is a sleep disorder characterized by partial and/or intermittent complete upper airways obstruction, was associated with deficits in pulmonary and respiratory muscle function. Inspiratory muscle training (IMT) has been reported as an effective treatment to improve respiratory muscle function and decrease OSA symptoms in adults with OSA, however, its effects on pulmonary and respiratory muscle function in children and adolescents with OSA and obesity remain unknown. Thus, this study aimed to investigate the feasibility and effect of IMT on pulmonary and respiratory muscle function of children and adolescents with OSA and obesity. A single group repeated measures study was conducted in five children and adolescents with OSA and obesity. A home-based IMT was performed with an initial training load at 60% of maximal inspiratory pressure (MIP). The IMT consisted of 80 breaths per day, sevendays weeklyfor 12 weeks with progressively increased load every three weeks. The outcomes included pulmonary function variables, MIP, and maximal voluntary ventilation (MVV) were the primary outcomes, and the Sleep Related Breathing Disorder-Pediatric Sleep Questionnaire (SRBD-PSQ) score was a secondary outcome. All outcomes were measured at baseline and after training at week 3, 6, 9, and 12. The results found that from 12-week of IMT to baseline, participants had increased in MIP, varying from 8.0% to 83.5%. Maximal voluntary ventilation (MVV) was increased, ranging from 0.1% to 36.1%. The Sleep Related Breathing Disorder-Pediatric Sleep Questionnaire (SRBD-PSQ) score were decreased. However, the extent of improvement in these variables were varied among individuals. There were no changes in pulmonary function variables. No adverse event wasobserved during evaluation and IMT, except one patient who had recurrent adenoid hypertrophy at week 10 of training. Thus, improvements in respiratory muscle functionand sleep apnea symptoms after IMT but not pulmonary function, suggesting the feasibility of IMT for OSA management in children and adolescents with OSA and obesity.