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Sleep Med Res > Volume 13(1); 2022 > Article
Sleep Medicine Research 2022;13(1): 8-14.
doi: https://doi.org/10.17241/smr.2022.01270
Outcomes of Intranasal Corticosteroid Treatment and Associated Factors in Children With Clinically Diagnosed Obstructive Sleep Apnea
Trakarnta Iadprapal MD1 , Wanaporn Anuntaseree MD1 , Nannapat Pruphetkaew MSc2 , Kanokpan Ruangnapa MD1 , Kantara Saelim MD1 , Pharsai Prasertsan MD1
1Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
2Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Corresponding Author: Wanaporn Anuntaseree ,Tel: +6674451250, Fax: +6674429618, Email: awanapor@medicine.psu.ac.th
Received: March 18, 2022.  Revised: June 1, 2022.  Accepted: June 3, 2022.
Abstract
Background and Objective     Many studies have supported the potential effect of anti-inflammatory medications treatment for childhood obstructive sleep apnea (OSA). This study aimed to evaluate the outcomes of intranasal corticosteroid treatment in children with OSA symptoms and adenoid hypertrophy (AH), and to identify factors associated with the treatment outcome.
Methods     This retrospective study included children aged 1–15 years who snored, had sleeprelated symptoms, and received intranasal corticosteroid treatment for 4–16 weeks. Treatment outcome was considered a success if all symptoms were completely resolved or if the child still snored without sleep-related symptoms; treatment was considered a failure if the child still snored and had concomitant sleep-related symptoms.
Results     Among the 328 eligible children, 109 (33.2%) experienced treatment failure. The age of the children was significantly higher in the failure group than in the success group (median [interquartile range], 5.5 [3.4, 8.4] vs. 4.2 [3.2, 6.3]; p = 0.004). The percentage of children with allergic rhinitis (AR) symptoms at follow-up visit was also significantly higher in the failure group than in the success group (44% vs. 27.9% with mild AR and 9.2% vs. 4.1% with moderateto-severe AR, p < 0.001). Multiple logistic regression revealed a significant association between treatment failure and older age (odds ratio [95% confidence interval], 1.13 [1.04–1.23]) and presence of mild AR (2.29 [1.39–3.77]) and moderate-to-severe AR (3.17 [1.20–8.39]).
Conclusions     Among children with OSA and AH, one-third experienced treatment failure, and the associated factors were older age and presence of AR symptoms.
Key Words: Corticosteroid; Snoring; Obstructive sleep apnea; Adenoid hypertrophy; Allergic rhinitis