Debra M Don, Beth Osterbauer, Divya Gowthaman, Laurel Fisher, Emily S Gillett
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引用次数: 0
Abstract
Background: The conventional measure of sleep fragmentation is via polysomnographic evaluation of sleep architecture. Adults with OSA have disruption in their sleep cycles and spend less time in deep sleep stages. However, there is no available evidence to suggest that this is also true for children and published results have been inconclusive.
Objective: To determine polysomnographic characteristics of sleep architecture in children with OSA and investigate effects relative to OSA severity.
Methods: Overnight polysomnograms (PSG) of children referred for suspected OSA were reviewed. Subjects were classified by apnea hypopnea index (AHI). PSG parameters of sleep architecture were recorded and analyzed according to OSA severity.
Results: Two hundred and eleven children were studied (median age of 7.0 years, range 4-10 years) Stage N1 sleep was longer while stage N2 sleep and REM sleep was reduced in the OSA group when compared to those without OSA (6.10 vs 2.9, P < .001; 42.0 vs 49.7, P < .001; 14.0 vs 15.9, P = .05). The arousal index was also higher in the OSA group (12.9 vs 8.2, P < .001). There was a reduction in sleep efficiency and total sleep time and an increase in wake after sleep onset noted in the OSA group (83.90 vs 89.40, P = .003; 368.50 vs 387.25, P = .001; 40.1 ± 35.59 vs 28.66 ± 24.14, P = .007; 29.00 vs 20.50; P = .011). No significant difference was found in N3 sleep stage (33.60 vs 30.60, P = .14).
Conclusion: We found evidence that children with OSA have a disturbance in their sleep architecture. The changes indicate greater sleep fragmentation and more time spent in lighter stages of sleep. Future research is needed and should focus on more effective methods to measure alterations in sleep architecture.
背景：传统的睡眠片段测量方法是通过多导睡眠图评估睡眠结构。患有 OSA 的成年人睡眠周期紊乱，深睡眠阶段的时间较少。然而，目前还没有证据表明儿童的情况也是如此，已发表的结果也没有定论：目的：确定 OSA 患儿睡眠结构的多导睡眠图特征，并研究与 OSA 严重程度相关的影响：方法：对因怀疑患有 OSA 而转诊的儿童的夜间多导睡眠图（PSG）进行审查。根据呼吸暂停低通气指数（AHI）对受试者进行分类。根据 OSA 严重程度记录和分析睡眠结构的 PSG 参数：与无 OSA 的儿童相比，OSA 组儿童的 N1 阶段睡眠时间较长，而 N2 阶段睡眠和快速动眼期睡眠时间较短（6.10 对 2.9，P P = .05）。OSA 组的唤醒指数也更高（12.9 vs 8.2，P P = .003；368.50 vs 387.25，P = .001；40.1 ± 35.59 vs 28.66 ± 24.14，P = .007；29.00 vs 20.50；P = .011）。N3睡眠阶段无明显差异（33.60 vs 30.60，P = .14）：结论：我们发现有证据表明，患有 OSA 的儿童睡眠结构紊乱。结论：我们发现有证据表明，患有 OSA 的儿童的睡眠结构出现了紊乱，这些变化表明睡眠碎片更多，在浅睡眠阶段花费的时间更长。未来的研究还需要更有效的方法来测量睡眠结构的变化。
期刊介绍：
The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.
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