Tal Asher, Bar Amir, Leiberman Alberto, Tarasiuk Ariel
Department of Pediatrics B, Soroka Medical Center, Ben-Gurion University of the Negev, PO Box 151, Beer-Sheva, Israel.
Chest. 2003 Sep;124(3):948-53. doi: 10.1378/chest.124.3.948.
To compare the effect of adenotonsillectomy on rapid eye movement (REM)- and non-REM-related respiratory and sleep architecture characteristics in children with obstructive sleep apnea syndrome (OSAS).
This prospective study evaluated 36 children (median age, 6.9 years; range, 1.8 to 12.6 years) with OSAS using polysomnography before and a few months after adenotonsillectomy. Primary outcomes included the number of obstructive apnea and hypopnea and arousals per hour of sleep.
At 4.6 months (range, 1 to 16 months) after adenotonsillectomy, there was a significant improvement of all respiratory parameters. The median respiratory disturbance index (RDI) decreased from 4.1/h (range, 0 to 85/h) to 0.9/h (range, 0 to 13/h) after adenotonsillectomy (p < 0.0001). The median non-REM RDI decreased from 3.0/h (range, 0 to 89/h) to 0.4/h (range, 0 to 13/h) [p < 0.001] as compared with REM RDI, which decreased from 7.8/h (range, 0 to 69/h) to 2.3/h (range, 0 to 54/h) after adenotonsillectomy (p < 0.01). Median arousal index decreased following adenotonsillectomy from 17.5/h (range, 7 to 57/h) to 14.0/h (range, 6 to 47/h) [p < 0.03].
Adenotonsillectomy resulted in a greater improvement in non-REM RDI as compared with REM-RDI, and a decrease in the number of arousals.
比较腺样体扁桃体切除术对阻塞性睡眠呼吸暂停综合征（OSAS）患儿快速眼动（REM）相关和非REM相关呼吸及睡眠结构特征的影响。
这项前瞻性研究对36例OSAS患儿（中位年龄6.9岁；范围1.8至12.6岁）在腺样体扁桃体切除术前及术后数月进行多导睡眠图评估。主要结局包括每小时睡眠中阻塞性呼吸暂停、呼吸不足及觉醒的次数。
腺样体扁桃体切除术后4.6个月（范围1至16个月），所有呼吸参数均有显著改善。腺样体扁桃体切除术后，呼吸紊乱指数（RDI）中位数从4.1次/小时（范围0至85次/小时）降至0.9次/小时（范围0至13次/小时）（p<0.0001）。与REM相关RDI相比，非REM相关RDI中位数从3.0次/小时（范围0至89次/小时）降至0.4次/小时（范围0至13次/小时）[p<0.001]，而REM相关RDI在腺样体扁桃体切除术后从7.8次/小时（范围0至69次/小时）降至2.3次/小时（范围0至54次/小时）（p<0.01）。腺样体扁桃体切除术后觉醒指数中位数从17.5次/小时（范围7至57次/小时）降至14.0次/小时（范围6至47次/小时）[p<0.03]。
与REM相关RDI相比，腺样体扁桃体切除术使非REM相关RDI有更大改善，且觉醒次数减少。
