pulmicort and Snoring

Although it is anecdotally known that nasal obstruction is associated with snoring, it remains unknown whether the application of nasal steroids could decrease oral/oro-nasal breathing and increase nasal breathing, and subsequently decrease snoring indices. This study evaluated the effect of nasal budesonide on breathing route pattern and snoring. Twenty-four snorers were enrolled in a randomized, double-blind, crossover trial of 1-week treatment with nasal budesonide compared with 1-week intervention with nasal placebo. At the start and end of each treatment period, patients underwent nasal resistance measurement and overnight polysomnography with concomitant measurement of breathing route pattern and snoring. Twelve patients were randomly assigned to a 1-week treatment with nasal budesonide, followed by 2-week washout period and a 1-week intervention with the nasal placebo; and 12 patients were randomly assigned to a 1-week intervention with nasal placebo, followed by 2-week washout period and a 1-week treatment with nasal budesonide. Nasal budesonide was associated with a decrease in oral/oro-nasal breathing epochs and concomitant increase in nasal breathing epochs, decrease of snoring frequency by [median (interquartile range)] 15.8% (11.2-18.8%), and an increase of rapid eye movement sleep; snoring intensity decreased only in patients with increased baseline nasal resistance by 10.6% (6.8-14.3%). The change in nasal breathing epochs was inversely related to the change in snoring frequency (Rs = 0.503; P < 0.001). Nasal budesonide in snorers can increase nasal breathing epochs, modestly decrease snoring frequency and increase rapid eye movement sleep.

Topics: Administration, Intranasal; Adult; Budesonide; Cross-Over Studies; Double-Blind Method; Female; Humans; Male; Nasal Obstruction; Polysomnography; Respiration; Sleep, REM; Snoring

To analyze the method and the effect of airway intervention before tracheal extubation in post-anesthesia cure unit (PACU) after anesthesia when removing the tonsil under general anesthesia and adenoidectomy under nasal endoscope on children with snoring.. 46 cases diagnosed as snoring were executively selected in this study. The cases were randomly divided into the control group (n = 22) and the observation group (n = 24). For airway intervention after general anesthesia during the recovery period, the control group was treated with intravenous injection of 0.5 μg/kg remifentanil, whereas the observation group was treated with atomization inhalation of 15 mg ambroxol hydrochloride and 0.5 mg budesonide suspension.. The clinical effects of both methods were compared and analyzed for statistical analysis. The blood pressure, heart rate and blood oxygen saturation at 30 min and 10 min after extubation in the control group was significantly more stable than those in the observation group (p < 0.05). The alertness/sedation (OAA/S) score in the observation group was significantly higher than that in the control group (p < 0.05). The prevalence rate of complications after extubation in the two groups was not statistically significant (p > 0.05). The levels of serum cortisol (Cor) and IL-8 in the control group were significantly lower than those in the observation group (p < 0.05).. Both methods are effective for treatment of airway intervention concerned with snoring children after general anesthesia during the recovery period. The effect of remifentanil on hemodynamics is relatively huge compared with that of atomization inhalation.

Topics: Adenoidectomy; Adolescent; Airway Extubation; Ambroxol; Anesthesia Recovery Period; Anesthesia, General; Blood Pressure; Budesonide; Case-Control Studies; Child; Female; Heart Rate; Humans; Hydrocortisone; Interleukin-8; Male; Oximetry; Piperidines; Remifentanil; Snoring

Nocturnal enuresis has been associated with obstructive sleep apnea-hypopnea and may resolve after adenotonsillectomy. Nasal corticosteroids have improved symptoms and polysomnography findings in children with snoring. Two children with primary nocturnal enuresis, chronic nasal obstruction, and loud snoring underwent polysomnography. The apnea-hypopnea index was 4.9 and 7.3 episodes/hr, and the oxygen desaturation of hemoglobin index was 4.6 and 5.2 episodes/hr. After administration of budesonide, the frequency of snoring decreased, the polysomnography findings improved, and the enuresis resolved completely. Six months after treatment, both children were still dry at night. Administration of nasal corticosteroids is associated with resolution of enuresis in children with mild obstructive sleep-disordered breathing.

Topics: Administration, Intranasal; Budesonide; Child; Enuresis; Female; Humans; Male; Nasal Obstruction; Remission Induction; Snoring

Nasal corticosteroids improve polysomnography indices but not symptoms in children with mild to moderate sleep-disordered breathing. We hypothesized that administration of nasal corticosteroids for 4 weeks to snoring children with only mild elevation in their apnea-hypopnea index would improve both polysomnography findings and symptoms of sleep-disordered breathing. Budesonide 50 mcg per nostril twice daily was administered for 4 weeks to children (2-14 years old) with habitual snoring and an apnea-hypopnea index of 1-10 episodes/hr. Subjects were evaluated before treatment and at 2 weeks and 9 months after its completion. Primary outcome variables were changes in apnea-hypopnea index and symptom score. Twenty-seven children were studied. At 2 weeks, the mean apnea-hypopnea index decreased from 5.2 (+/-2.2) episodes/hr to 3.2 (+/-1.5) episodes/hr, and median oxygen desaturation of hemoglobin index fell from 3.1 (0.4-8.2) to 1.9 (0.2-5.4) (P < 0.0001). Mean symptom score was 1.33 (+/-2.11) at baseline, and decreased to -0.008 (+/-2.24) at 2 weeks after treatment and to -1.08 (+/-1.75) at 9 months after treatment (P < 0.05). Four weeks of nasal budesonide improved both polysomnography findings and symptoms in children with mild sleep-disordered breathing. The clinical effect is maintained for several months after treatment.

Topics: Administration, Intranasal; Adolescent; Adrenal Cortex Hormones; Bronchodilator Agents; Budesonide; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Patient Selection; Polysomnography; Sleep Apnea, Obstructive; Snoring