Ebert Charles S, Drake Amelia F
Department of Otolaryngology--Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7070, USA.
Otolaryngol Head Neck Surg. 2004 Dec;131(6):814-26. doi: 10.1016/j.otohns.2004.09.017.
The goal of this review is to provide a synthesis of the current literature addressing the effects of sleep-disordered breathing on cognition and behavior in children aged 2-18.
A computerized search was performed to include studies between 1966 and 2001. Studies were assessed based on research question, sampling, intervention, outcomes, confounding, and statistical methods. Sensitivity analyses were performed for quantitative assessments of selection bias, misclassification, and confounding.
Seventeen reports with 5312 patients were reviewed. The majority of these studies demonstrated poor sampling, insufficient consideration of confounders, and imprecise use of statistical tools. However, there was little evidence of bias in two studies when scrutinized using a sensitivity analysis.
Despite suggested links between daytime behavior problems and neurocognitive deficits, there is little certainty for causality based on the quality of the evidence.
By discussing the quality of the current evidence, we hope to improve study design and contribute to the development of an understanding of this complex topic.
本综述的目的是综合当前有关睡眠呼吸紊乱对2至18岁儿童认知和行为影响的文献。
进行了计算机化检索，纳入1966年至2001年间的研究。根据研究问题、抽样、干预、结果、混杂因素和统计方法对研究进行评估。对选择偏倚、错误分类和混杂因素进行定量评估时进行了敏感性分析。
对17份报告（涉及5312名患者）进行了综述。这些研究大多存在抽样不佳、对混杂因素考虑不足以及统计工具使用不精确的问题。然而，使用敏感性分析仔细审查时，两项研究几乎没有偏倚证据。
尽管有迹象表明白天行为问题与神经认知缺陷之间存在联系，但基于证据质量，因果关系几乎无法确定。
通过讨论当前证据的质量，我们希望改进研究设计，并有助于对这一复杂主题的理解发展。
