The Effect of Breathing Exercises on Arterial Blood Gases and Enuresis in Children with Sleep-Disordered Breathing

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Psychology, Islamic Azad University, Naein Branch, Isfahan, Iran

2 Professor, Department of Pediatrics, School of Medicine AND Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Dysfunction in normal breathing affects the enuresis in children. The aim of this study was to investigate the effects of breathing exercises on arterial blood gases and enuresis in children suffered from the sleep-disordered breathing.Methods: This study was conducted in the year of 2011, by a semi-experimental design with the control group, among 40 children aged 6-12 years. Subjects were selected based on the criteria of mouth breathing and enuresis; they had sleep-disordered breathing and were referred to the urologist's office affiliated to the Isfahan University of Medical Sciences, Iran. Participants were examined based on the criteria of nocturnal enuresis, oral breathing, and nocturnal snoring. Subsequently, they were randomly assigned to the case and control groups. In the case group, the breathing exercises were performed for 45 minutes for four weeks in prior to sleeping. Subsequently, the arterial blood gases were measured and the frequency of enuresis and the respiratory rates (RR) were recorded. Data were analyzed using repeated measurements of ANOVA, paired-t, independent-t, Wilcoxon signed-rank, and Mann-Whiney U tests.Findings: After intervention, O2 saturation and PaO2 were higher (P < 0.001) and RR and PaCO2 were lower in the case group (P < 0.001). The enuresis decreased significantly in the case group, too (P < 0.001).Conclusion: This study suggests that the breathing exercises may increase arterial oxygen and reduce the frequency of enuresis in the patients with the oral breathing and nocturnal snore.

Keywords

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-IV-TR. Arlington, VA: American Psychiatric Publishing; 2000.
  2. Krakow B, Melendrez D, Warner TD, Clark JO, Sisley BN, Dorin R, et al. Signs and symptoms of sleep-disordered breathing in trauma survivors: a matched comparison with classic sleep apnea patients. J Nerv Ment Dis 2006; 194(6): 433-9.
  3. Brockmann PE, Urschitz MS, Noehren A, Sokollik C, Schlaud M, Poets CF. Risk factors and consequences of excessive autonomic activation during sleep in children. Sleep Breath 2011; 15(3): 409-16.
  4. Brown BJ, Habelt S, Koral K, Sacco D, Herman JH, Baker LA. Secondary nocturnal enuresis caused by central sleep apnea from Chiari malformation type 1. J Pediatr Urol 2010; 6(3): 265-9.
  5. Sahin U, Ozturk O, Ozturk M, Songur N, Bircan A, Akkaya A. Habitual snoring in primary school children: prevalence and association with sleep-related disorders and school performance. Med Princ Pract 2009; 18(6): 458-65.
  6. Jeyakumar A, Rahman SI, Armbrecht ES, Mitchell R. The association between sleep-disordered breathing and enuresis in children. Laryngoscope 2012; 122(8): 1873-7.
  7. Schluter B, De SG, Trowitzsch E, Andler W. Diagnostics and management of sleep-related respiratory disturbances in children with skeletal dysplasia caused by FGFR3 mutations (achondroplasia and hypochondroplasia). Georgian Med News 2011; (196-197): 63-72.
  8. Waleed FE, Samia AF, Samar MF. Impact of sleep-disordered breathing and its treatment on children with primary nocturnal enuresis. Swiss Med Wkly 2011; 141: w13216.
  9. Chang P, Chen WJ, Tsai WY, Chiu YN. An epidemiological study of nocturnal enuresis in Taiwanese children. BJU Int 2001; 87(7): 678-81.
  10. Yeung CK, Sreedhar B, Sihoe JD, Sit FK, Lau J. Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study. BJU Int 2006; 97(5): 1069-73.
  11. Hubeaux K, Deffieux X, Raibaut P, Le BF, Jousse M, Amarenco G. Evidence for autonomic nervous system dysfunction in females with idiopathic overactive bladder syndrome. Neurourol Urodyn 2011; 30(8): 1467-72.
  12. Vesna ZD, Milica L, Stankovic I, Marina V, Andjelka S. The evaluation of combined standard urotherapy, abdominal and pelvic floor retraining in children with dysfunctional voiding. J Pediatr Urol 2011; 7(3): 336-41.
  13. Baugh RF, Archer SM, Mitchell RB, Rosenfeld RM, Amin R, Burns JJ, et al. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg 2011; 144(1 Suppl): S1-30.
  14. Moradyan ST, Farahani M, Mohammadi N, Jamshidi R. The effect of planned breathing exercises on oxygenation in patients after coronary artery bypass surgery. Cardiovascular Nursing 2012; 1(1): 8-14.
  15. Vanaki M. Important points in the instruction manual of sampling and sample transport for the measurement of blood gases. Lab News 2012; 107: 30.
  16. Satchidananda S. The Yoga Sutras of Patanjali. Reprint ed. Buckingham, VA: Integral Yoga Publications; 2012.
  17. Iyengar BKS, Menuhin Y. Light on yoga: yoga dipika. New York, NY: Schocken Books Inc; 1979.
  18. Carotenuto M, Esposito M, Pascotto A. Facial patterns and primary nocturnal enuresis in children. Sleep Breath 2011; 15(2): 221-7.
  19. Ezadi Avanji F, Afshar M, Hajibagheri A. The effect excersise of breathing with pursed-lips breathing in patient suffered of chronic distructive pulmonary diseases. J Shaheed Sadoughi Univ Med Sci 2006; 14(2): 61-7. [In Persian].
  20. Bianchi R, Gigliotti F, Romagnoli I, Lanini B, Castellani C, Binazzi B, et al. Patterns of chest wall kinematics during volitional pursed-lip breathing in COPD at rest. Respir Med 2007; 101(7): 1412-8.
  21. Collins EG, Langbein WE, Fehr L, Maloney C. Breathing pattern retraining and exercise in persons with chronic obstructive pulmonary disease. AACN Clin Issues 2001; 12(2): 202-9.
  22. Mueller RE, Petty TL, Filley GF. Ventilation and arterial blood gas changes induced by pursed lips breathing. J Appl Physiol 1970; 28(6): 784-9.
  23. Djurhuus JC, Norgaard JP, Hjalmas K. What is an acceptable treatment outcome? Scand J Urol Nephrol Suppl 1997; 183: 75-7.
  24. Hershey HG, Stewart BL, Warren DW. Changes in nasal airway resistance associated with rapid maxillary expansion. Am J Orthod 1976; 69(3): 274-84.
  25. Keall CL, Vig PS. An improved technique for the simultaneous measurement of nasal and oral respiration. Am J Orthod Dentofacial Orthop 1987; 91(3): 207-12.
  26. Hillegass E. Essentials of cardiopulmonary physical therapy. 1st ed. Philadelphia, PA: Saunders; 1994.
  27. Hodgkin EJ, Celi RB, Connors LG. Pulmonary rehabilitation; guidelines to success. 3rd ed. Philadelphia, PA; 2000. p. 12-6, 22-9.
  28. Ugalde V, Breslin EH, Walsh SA, Bonekat HW, Abresch RT, Carter GT. Pursed lips breathing improves ventilation in myotonic muscular dystrophy. Arch Phys Med Rehabil 2000; 81(4): 472-8.
  29. Yazici M, Arbak P, Balbay O, Maden E, Erbas M, Erbilen E, et al. Relationship between arterial blood gas values, pulmonary function tests and treadmill exercise testing parameters in patients with COPD. Respirology 2004; 9(3): 320-5.
  30. Zivkovic V, Lazovic M, Vlajkovic M, Slavkovic A, Dimitrijevic L, Stankovic I, et al. Diaphragmatic breathing exercises and pelvic floor retraining in children with dysfunctional voiding. Eur J Phys Rehabil Med 2012; 48(3): 413-21.
  31. Ghahri Sarabi A, Heidarizadeh Kh, Ebrahimi N, Alavimajd H, Yaghmaei F. The effect of breathing exercises on performance of chemical warfare. J Nurs Midwifery Shahid Beheshti Univ Med Sci 2007: 17(58): 13-20
  32. Li HY, Lee LA. Sleep-disordered breathing in children. Chang Gung Med J 2009; 32(3): 247-57.
  33. Norgaard JP, Rittig S, Djurhuus JC. Nocturnal enuresis: an approach to treatment based on pathogenesis. J Pediatr 1989; 114(4 Pt 2): 705-10.
Journal of Isfahan Medical School
Volume 31, Issue 235 - Serial Number 235
March and April 2013
Pages 611-618

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History

  • Receive Date: 23 November 2012
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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