de Miguel-Díez Javier, Villa-Asensi José R, Alvarez-Sala José L
Department of Pulmonology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
Sleep. 2003 Dec 15;26(8):1006-9. doi: 10.1093/sleep/26.8.1006.
To assess the prevalence of sleep-disordered breathing in a nonselected group of children with Down syndrome and to determine significant predisposing factors for this condition.
Prospective study.
Tertiary care university hospital in Madrid, Spain.
The study population included 108 consecutive children with Down syndrome (mean [SD] age, 7.9 [4.5] years; range, 1-18 years) independently of whether or not suggestive clinical features of sleep-disordered breathing were present.
In addition to history, physical examination, and lateral radiographs of the nasopharynx, all participants underwent an overnight cardiorespiratory polygraphy at the hospital using a portable ambulatory device (Apnoescreen II plus). An apnea-hypopnea index of at least 3 was required for defining the presence of sleep-disordered breathing.
The prevalence of sleep-disordered breathing was 54.6%, with a significantly higher prevalence in boys (64.7%) than in girls (38.5%) (P < .05). The group with sleep-disordered breathing was significantly younger (6.4 [3.9] years) than those with normal polysomnographic recordings (9.6 [4.6] years) (P < .001). In the multivariate analysis, age (less than 8 years old) (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.40, 8.06); male sex (OR, 3.32; 95% CI, 1.32, 8.12); and tonsillar hyperplasia (OR, 5.24; 95% CI, 1.52, 19.03) were significantly associated with sleep-disordered breathing. Body mass index, adenoid hyperplasia, previous tonsillectomy or adenoidectomy, congenital heart disease, malocclusion, and macroglossia did not affect the prevalence of sleep-disordered breathing.
The prevalence of sleep-disordered breathing in children with Down syndrome is very high, particularly in boys. Tonsillar hyperplasia may play a role in the pathophysiology of sleep-disordered breathing in these patients. Adenoid hyperplasia, obesity, and congenital heart disease were not important risk factors for sleep-disordered breathing.
评估非特定唐氏综合征儿童群体中睡眠呼吸障碍的患病率，并确定该病症的重要诱发因素。
前瞻性研究。
西班牙马德里的三级护理大学医院。
研究人群包括108名连续纳入的唐氏综合征儿童（平均[标准差]年龄为7.9[4.5]岁；范围为1至18岁），无论是否存在睡眠呼吸障碍的提示性临床特征。
除了病史、体格检查和鼻咽部侧位X线片外，所有参与者均在医院使用便携式动态设备（Apnoescreen II plus）进行了夜间心肺多导睡眠监测。睡眠呼吸障碍的定义要求呼吸暂停低通气指数至少为3。
睡眠呼吸障碍的患病率为54.6%，男孩（64.7%）的患病率显著高于女孩（38.5%）（P<.05）。有睡眠呼吸障碍的组明显比多导睡眠图记录正常的组年轻（6.4[3.9]岁）（9.6[4.6]岁）（P<.001）。在多变量分析中，年龄（小于8岁）（比值比[OR]，3.36；95%置信区间[CI]，1.40，8.06）；男性（OR，3.32；95%CI，1.32，8.12）；以及扁桃体增生（OR，5.24；95%CI，1.52，19.03）与睡眠呼吸障碍显著相关。体重指数、腺样体增生、既往扁桃体切除术或腺样体切除术、先天性心脏病、错牙合畸形和巨舌症均不影响睡眠呼吸障碍的患病率。
唐氏综合征儿童睡眠呼吸障碍的患病率非常高，尤其是男孩。扁桃体增生可能在这些患者睡眠呼吸障碍的病理生理过程中起作用。腺样体增生、肥胖和先天性心脏病不是睡眠呼吸障碍的重要危险因素。
