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Collaborative Care Model for Allergic Rhinitis With Obstructive Sleep Apnea From Prevention to Treatment.

Not Applicable
Conditions
Pediatric Sleep Apnea
Interventions
Device: laser acupuncture (RJ laser S/N 1813458)
Drug: western medicine
Registration Number
NCT04621513
Lead Sponsor
China Medical University Hospital
Brief Summary

In this project,the investigators aim to establish a Collaborative Care Model of TCM and Western Medicine to improve the quality of life and symptoms of AR with OSA children and educate care-givers diet and massage information to improve self-care ability and alleviate anxiety for parents. In addition, the investigators will use portable oxymeter to detect the change of SpO2 and respiratory arousal index daily at home and evaluate sensitivity and specificity of portable oxymeter device applied in OSA. The investigators want to give holistic health care for participants and care-givers by this project. In addition, the investigators will build a training environment to provide medical education and training opportunity to teach medical students and clinician the knowledge of pediatric allergic rhinitis and obstructive sleep apnea by caring patients and learning from clinical cases.

Detailed Description

Obstructive sleep apnea (OSA) affects 1-6% among children and has negative influence on day-time school performance and quality of sleep. It also cause failure to thrive,cardiovascular disease,and metabolic disease, which need early intervention. About 6% allergic rhinitis (AR) children would combine with OSA and refractory to treatment and need long-term intra-nasal corticosteroid or surgery if have moderate-severe OSA with adenoid-tonsillar hypertrophy. Some parents considering the side effect of steroid and risk of surgery will search Traditional Chinese Medicine (TCM) for help.

TCM is one kind of preventive medicine by educating people how to keep health by diet and massage. The breathing technique and "Teeth-Buckling and Salivary-Swallowing motion" noted in Inner Canon of the Yellow Emperor, one of the most important ancient Chinese medical text are compatible with myofunctional therapy for OSA. There are several studies revealed improve immune response in allergic rhinitis by TCM and severity of OSA by acupuncture.

In this project, the investigators aim to establish a Collaborative Care Model of TCM and Western Medicine to improve the quality of life and symptoms of AR with OSA children and educate care-givers diet and massage information to improve self-care ability and alleviate anxiety for parents. In addition, the investigators will use portable oxymeter to detect the change of SpO2 and respiratory arousal index daily at home and evaluate sensitivity and specificity of portable oxymeter device applied in OSA. The investigators want to give holistic health care for patients and care-givers by this project. In addition, the investigators will build a training environment to provide medical education and training opportunity to teach medical students and clinician the knowledge of pediatric allergic rhinitis and obstructive sleep apnea by caring patients and learning from clinical cases.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  1. Age less than 18 years old
  2. Patients with persistent, moderate to severe allergic rhinitis who have been diagnosed by ARIA (2014) diagnostic criteria
  3. AHI by polysomnography is >1 and diagnosis with obstructive sleep apnea.
Exclusion Criteria
  1. Abnormal craniofacial structure and require surgery.
  2. Patients with sleep apnea caused by muscular dysplasia of the upper respiratory tract ( eg. cerebral palsy, Down syndrome, and other congenital muscular hypoplasia).
  3. Mental or behavioral abnormalities that cannot cooperate with the researcher, such as schizophrenia, depression, suicidal ideation, etc.
  4. Allergy to the treatment previously
  5. Any disease or organ system dysfunction that may be life-threatening

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Collaborative Care Model of TCM and WMwestern medicineTraditional Chinese Medicine(TCM):laser acupuncture and massage education. Western Medicine (WM):intra-nasal corticosteroid with singulair
Collaborative Care Model of TCM and WMlaser acupuncture (RJ laser S/N 1813458)Traditional Chinese Medicine(TCM):laser acupuncture and massage education. Western Medicine (WM):intra-nasal corticosteroid with singulair
Western medicinewestern medicineWestern Medicine (WM):intra-nasal corticosteroid with singulair
Primary Outcome Measures
NameTimeMethod
The change of mean score of Obstructive Sleep Apnea-18 Questionnaire8 weeks

Evaluation quality of life pediatric Obstructive Sleep Apnea-18 ,(score:0-108)

Secondary Outcome Measures
NameTimeMethod
nasal volume8 weeks AND 12 weeks

Acoustic rhinometry

adenoid size8 weeks

Clemen and McMurray grade 1-4

The change of mean score of Sinus and Nasal Quality of Life Survey8 weeks

questionnaire for quality of life Sinus and Nasal disease (score:5-45)

The change of mean score of Pediatric Sleep Questionnaire8 weeks

For quality of sleep (score:0-22)

The change of mean score of SNAP IV ( Swanson, Nolan and Pelham questionnaire)8 weeks

for hyperactivity -tention deficiency disease (score:0-78)

Apnea-Hypopnea Index8 weeks

by polysomnography

adeonid nasopharnygeal ratio8 weeks

by X ray Cephalometry

tonsil size8 weeks

Friedman Grading Scale (grade 0-4)

Trial Locations

Locations (1)

China Medical University & Hospital

🇨🇳

Taichung, Taiwan

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