Blunden Sarah, Lushington Kurt, Lorenzen Berndt, Wong Johnny, Balendran R, Kennedy Declan
Centre for Sleep Research, Queen Elizabeth Hospital, Woodville, South Australia.
Sleep Breath. 2003 Dec;7(4):167-76. doi: 10.1007/s11325-003-0167-8.
Sleep breathing disorders (SBD) in children are reportedly underdiagnosed in general practice. A contributory factor may be parental underreporting of symptoms. This possibility was examined by comparing the frequency with which snoring was mentioned at general practitioner visits by parents with frequency that snoring was reported on questionnaire evaluation immediately prior to consultation. We also examined the effects of age and gender on SBD symptoms. Parents of 626 children aged 0 to 16 years attending their general practitioner for sick child visits completed selected items from the Sleep Disturbance Scale for Children and the Obstructive Sleep Apnea Syndrome Expanded Childhood Questionnaire. Parents and general practitioners were also asked if snoring was discussed at the current consultation visit or at a prior consultation visit in the previous 12 months. Eighteen percent (112 of 626) of children were frequent snorers (more than three times per week), whereas 0.6 to 5.0% of children snored and had one or more additional SBD symptom suggestive of obstructive sleep apnea. SBD symptoms tended to peak in early to middle childhood with few gender differences. We found that snoring was patently underreported by parents. In the children with a history of frequent snoring on questionnaire evaluation and where the reason for the consultation visit was documented, snoring was mentioned by parents at the current consultation visit in only 8% (8 of 100) of cases and at a prior consultation visit in only 15% (15 of 100) of cases. The present findings support a need for increased parental education regarding the symptoms and clinical significance of SBD.
据报道，儿童睡眠呼吸障碍（SBD）在全科医疗中普遍存在诊断不足的情况。一个促成因素可能是家长对症状的报告不足。通过比较家长在全科医生就诊时提及打鼾的频率与在咨询前立即进行的问卷调查评估中报告打鼾的频率，对这种可能性进行了研究。我们还研究了年龄和性别对SBD症状的影响。626名0至16岁因患病就诊于全科医生的儿童的家长完成了儿童睡眠障碍量表和阻塞性睡眠呼吸暂停综合征扩展儿童问卷中的选定项目。家长和全科医生还被问及在本次咨询就诊或过去12个月内的前一次咨询就诊时是否讨论过打鼾问题。18%（626名中的112名）的儿童经常打鼾（每周超过三次），而0.6%至5.0%的儿童打鼾并伴有一种或多种其他提示阻塞性睡眠呼吸暂停的SBD症状。SBD症状在儿童早期至中期往往达到峰值，性别差异不大。我们发现家长明显少报了打鼾情况。在问卷评估中有频繁打鼾史且就诊原因有记录的儿童中，家长在本次咨询就诊时仅在8%（100名中的8名）的病例中提及打鼾，在前一次咨询就诊时仅在15%（100名中的15名）的病例中提及打鼾。目前的研究结果支持需要加强对家长关于SBD症状和临床意义的教育。
