SELECTED ARTICLES FROM THE RECENT LITERATURE 2004
7/7/04
Nasal corticosteroids for snoring children
Summary
Background - Treatment with nasal corticosteroid sprays (Nas St) has been shown to improve findings in polysomography but not symptoms in children with moderate sleep-disordered breathing (sleep apnea.) The question remains whether Nas St treatment would have more impressive beneficial effects in snoring children with less pronounced sleep-disordered breathing.
Findings - Alexsopoulos et al of the Larissa Univ. Hospital in Greece studied the effects of budesonide (Bud), used as a Nas St, 50 mcg/nostril b.i.d. for 4 weeks in snoring children (ages 2-14 years) with mild sleep-disordered breathing. When evaluated 2 weeks and 9 months after discontinuing the Bud treatment, there was a significant reduction in the apnea-hypoprea index of sleep-disordered breathing, decreased symptoms and less oxygen desaturation of the blood.
Conclusions - Nasal Bud treatment for 4 weeks improves both polysomography indices and symptoms in snoring children with mild sleep disordered breathing. This beneficial effect lasts for several months after the 4 week Bud treatment.
Reference
Pediatr Pulmonol 2004;38:161-7
Editor's Comments
There are multiple causes of sleep disorder breathing, one of which is pronounced nasal congestion. I was surprised that a Nas St treatment which should help only those individuals with nasal inflammatory conditions leading to nasal congestion seemed to help most of the children studied here. Perhaps the presence of impressive snoring in all the children studied pre-selected those children in whom nasal congestion was the main pathogenic factor in the sleep-disordered breathing. I was also surprised that the beneficial effect of the Nas St treatment for only 4 weeks lasted an additional 9 months since the anti-inflammatory effect of Bud spray should have ceased well before 9 months.
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