Evaluating Positional Obstructive Sleep Apnea in Children: Prevalence, Characteristics, and Risk Factors.

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2024-10-03 eCollection Date: 2024-01-01 DOI:10.2147/NSS.S481742

Qian Wang, Guimin Huang, Ruikun Wang, Zhilong Cao, Jieqiong Liang, Mengyao Li, Qinglong Gu

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引用次数: 0

Abstract

Purpose: This study investigates the prevalence, risk factors, and clinical characteristics of positional obstructive sleep apnea (POSA) among pediatric patients diagnosed with obstructive sleep apnea (OSA).

Patients and methods: A total of 1,236 children aged 0 to 17 years who underwent nocturnal polysomnography (PSG) and completed the Sleep Questionnaire were included. After excluding those with an AHI <1, neurological or muscular disorders, or insufficient sleep time in specific positions, 908 patients remained: 158 with POSA and 750 with non-positional OSA (NPOSA). Propensity score matching (PSM) was applied at a 1:2 ratio, resulting in a final sample of 153 POSA and 306 NPOSA patients. Data analyses were performed using R software (version 4.2.3).

Results: The prevalence of POSA was 12.8%. After PSM, patients with POSA had a lower overall AHI (8.66 vs 10.30), REM-AHI (14.30 vs 17.40), and NREM-AHI (7.43 vs 8.77) compared to those with NPOSA. POSA patients also had a shorter total sleep time (411 vs 427 minutes), spent less time in the supine position (168 vs 225 minutes), and more time in non-supine positions (241 vs 202 minutes) than NPOSA patients. Additionally, while the supine AHI was higher in POSA patients (15.60 vs 10.30), the non-supine AHI was lower (5.00 vs 11.00) compared to NPOSA patients. The minimum oxygen saturation was slightly higher in POSA patients (0.88 vs 0.87). All differences were statistically significant (P < 0.05). Risk factors for POSA included mild OSA, allergic rhinitis, non-allergic rhinitis, and obesity.

Conclusion: The prevalence of POSA in children is lower than in adults, and its severity is less than that of NPOSA. Compared to NPOSA patients, POSA patients had significantly higher AHI during supine sleep and lower AHI during non-supine sleep. POSA patients also spent more time in non-supine positions, suggesting that avoiding supine sleep may help reduce apnea events. These findings highlight the importance of monitoring and managing sleep posture in POSA patients.

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评估儿童体位性阻塞性睡眠呼吸暂停：患病率、特征和风险因素。

目的：本研究调查了被诊断为阻塞性睡眠呼吸暂停（OSA）的儿童患者中体位性阻塞性睡眠呼吸暂停（POSA）的患病率、风险因素和临床特征：共纳入了 1236 名 0 至 17 岁的儿童，他们都接受了夜间多导睡眠图检查（PSG）并填写了睡眠问卷。在排除了有 AHI 的儿童后，得出了结果：POSA 患病率为 12.8%。在 PSM 之后，与 NPOSA 患者相比，POSA 患者的总体 AHI（8.66 vs 10.30）、REM-AHI（14.30 vs 17.40）和 NREM-AHI （7.43 vs 8.77）均较低。与 NPOSA 患者相比，POSA 患者的总睡眠时间更短（411 分钟对 427 分钟），仰卧位时间更短（168 分钟对 225 分钟），非仰卧位时间更长（241 分钟对 202 分钟）。此外，与 NPOSA 患者相比，POSA 患者的仰卧位 AHI 较高（15.60 对 10.30），而非仰卧位 AHI 较低（5.00 对 11.00）。POSA 患者的最低血氧饱和度略高（0.88 对 0.87）。所有差异均有统计学意义（P < 0.05）。POSA 的风险因素包括轻度 OSA、过敏性鼻炎、非过敏性鼻炎和肥胖：结论：POSA 在儿童中的发病率低于成人，其严重程度也低于 NPOSA。与 NPOSA 患者相比，POSA 患者仰卧睡眠时的 AHI 明显较高，而非仰卧睡眠时的 AHI 则较低。此外，POSA 患者保持非仰卧姿势的时间也更长，这表明避免仰卧睡眠可能有助于减少呼吸暂停事件的发生。这些发现强调了监测和管理 POSA 患者睡眠姿势的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.