哮喘和睡眠呼吸障碍在儿童腺扁桃体切除术中对打鼾的研究。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2024-12-04 DOI:10.1007/s11325-024-03210-1

Po-Yang Tsou, Seyni Gueye-Ndiaye, Krysta Lynn Gorman, Ariel Williamson, Sally Ibrahim, Scott Weber, David Zopf, Fauziya Hassan, Cristina Baldassari, Carlos Sendon, Rui Wang, Susan Redline, Dongdong Li, Kristie R Ross

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引用次数: 0

摘要

目的：虽然哮喘在睡眠呼吸障碍（SDB）患儿中很常见，但尚不清楚哮喘是否以及在多大程度上与SDB相关。我们的目标是描述轻度SDB （mSDB）儿童哮喘的危险因素，并评估哮喘与睡眠相关结局严重程度之间的关系。方法：对参加儿童鼾症儿童腺扁桃体切除术研究的3-12.9岁mSDB患儿进行横断面分析。睡眠相关结局包括SDB症状（儿童睡眠问卷-睡眠相关呼吸障碍量表（PSQ-SRBD））、SDB特异性生活质量（OSA-18）、嗜睡（修正Epworth嗜睡评分）以及多导睡眠图和活动图测量。哮喘的定义是由护理人员报告的当前哮喘症状和药物使用的诊断，或综合哮喘严重程度指数（CASI）评分≥4。结果：样本包括425名儿童(20.3%-黑人，17.4%-西班牙裔；投资女性51.7%)。哮喘患病率为19.1%（7.1%为中度至重度，12.0%为轻度）。在多变量调整分析中，环境烟草烟雾暴露和特应性标志物与哮喘有关。中至重度哮喘与PSQ-SRBD测量的OSA症状增加相关（对中至重度哮喘与无哮喘的调整效应估计）。95%可信区间):0.08;0.01, 0.15))和生活质量下降(β ^ adj；95%置信区间:7.5;1.20, 13.82))，唤醒指数(β ^ adj；95%置信区间:0.80;0.09, 1.51))。结论：mSDB患儿中重度哮喘与较差的生活质量和较严重的SDB症状相关。mSDB和哮喘共同危险因素的共同发生，以及患有这两种疾病的儿童更差的症状和生活质量，支持了预防和共同管理这两种疾病的协调策略。临床试验：小儿打鼾腺扁桃体切除术（PATS）， NCT02562040, https://clinicaltrials.gov/study/NCT02562040。

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Asthma and sleep disordered breathing in the pediatric adenotonsillectomy trial for snoring study.

Purpose: Although asthma is common in children with sleep-disordered breathing (SDB), it is unclear whether and to what extent asthma is associated with SDB-related outcomes. Our objectives are to describe risk factors for asthma among children with mild SDB (mSDB) and assess the association between asthma and the severity of sleep-related outcomes.

Methods: Cross-sectional analyses were conducted for children aged 3-12.9 years with mSDB enrolled in Pediatric Adenotonsillectomy for Snoring Children Study. Sleep-related outcomes included SDB symptoms (Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder scale (PSQ-SRBD)), SDB-specific quality of life (OSA-18), sleepiness (modified Epworth Sleepiness Score) and polysomnographic and actigraphic measures. Asthma was defined by caregiver-reported diagnosis with current asthma symptoms and medication use, or a Composite Asthma Severity Index (CASI) score ≥ 4. Asthma was further categorized into mild (CASI < 4) and moderate-to-severe (CASI ≥ 4). Regression analyses were conducted to identify asthma risk factors and estimate the associations between mild and moderate-to-severe asthma with sleep-related outcomes.

Results: The sample included 425 children (20.3%-Black, 17.4%-Hispanic; 51.7%-female). The prevalence of asthma was 19.1% (7.1% moderate-to-severe, 12.0% mild). Environmental tobacco smoke exposure and markers of atopy were associated with asthma in multivariable-adjusted analyses. Moderate-to-severe asthma was associated with increased OSA symptoms measured by PSQ-SRBD (adjusted effect estimate for moderate-to-severe vs. no asthma ( $\hat{β}$ _adj; 95%CI): 0.08; 0.01, 0.15)) and decreased quality of life measured by OSA-18 ( $\hat{β}$ _adj; 95%CI: 7.5; 1.20, 13.82)), and a small increase in the arousal index ( $\hat{β}$ _adj; 95%CI: 0.80; 0.09, 1.51)).

Conclusion: Moderate-to-severe asthma was associated with worse QoL and greater SDB symptoms among children with mSDB. The co-occurrence of common risk factors for mSDB and asthma and worse symptoms and quality of life in children with both conditions support coordinated strategies for prevention and co-management of both disorders.

Clinical trial: Pediatric Adenotonsillectomy for Snoring (PATS), NCT02562040, https://clinicaltrials.gov/study/NCT02562040.

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.