Efeitos do método Buteyko nos distúrbios do sono de crianças asmáticas respiradoras orais: estudo controlado randomizado

Abstract

Introduction: Asthma is one of the most common chronic diseases in children, with important morbidity and mortality in affected individuals. Oral breathing is also a respiratory disorder with a high prevalence in the child population. Non-pharmacological therapy has been widely used in the search for alternative therapies in the treatment of this pathology, among them, the Buteyko method is found. Objective: To evaluate the effects of the Buteyko method as an adjunct therapy in the treatment of asthmatic mouth breathing children. Materials and methods: This is a randomized, single-blind, controlled study in which 35 children with mild or moderate asthma between 7 and 12 years of age and speech-language pathologist diagnosis were divided into two groups (Buteyko and control). All the children underwent respiratory evaluation in two moments: initial and final. Anthropometric assessments, sleep disturbances through the Sleep Disorders Scale in Children, pulmonary function (ventilometry and spirometry) and symptom reporting (hospitalization and absences at school) were performed. The children of the Buteyko group (20 children) conducted face-to-face group training of the Buteyko method twice a week for 3 weeks and weekly monitoring of symptom control was performed. A video was provided with guidelines for performing the Buteyko method daily at home for 3 weeks. The children in the control group (15 children) received an educational class and were contacted weekly to report their symptoms. Data were analyzed using SPSS 20.0 software, with a significance level of 5%. The normality of the data was verified by the Shapiro-Wilk test, the Levene test for homogeneity of variances and two-way ANOVA to verify intra and intergroup differences. The unpaired Student's t-test was performed to compare the height and Mann-Whitney variables for comparison of variables weight, age, percentile and school absences between groups. Fisher's exact test was performed to compare the distribution of genders and the classification of asthma and chi-square to compare the percentage of sleep disorders presented by children initially. Results: After training, the Buteyko group significantly improved scores on sleep disturbances, disorders of arousal, sleep-wake transition disorders (SWTD), total sleep disturbance scores, forced vital capacity (FVC), peak of expiratory flow and forced expiratory flow between 25% and 75% of FVC (FEF25-75%). Compared to the control group, in the final evaluation, the Buteyko group also improved SWTD, total sleep score, FEF25-75%, the relation between forced expiratory volume in the first second with FVC and number of school absences. Conclusion: The training with Buteyko method provided improvement of sleep disorders, lung function and reduction in the number of absences in the school of asthmatic mouth breathing children.