Pereira Kevin D, Roebuck Jeremy C, Howell Lori
Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center at Houston, 77030, USA.
Arch Otolaryngol Head Neck Surg. 2005 Nov;131(11):1014-6. doi: 10.1001/archotol.131.11.1014.
To determine the association between body position and obstructive events during sleep as determined by polysomnography (PSG) in very young children (age, < or = 3 years) with obstructive sleep apnea syndrome.
Retrospective chart review.
Children aged 3 years and younger who underwent PSG to evaluate obstructive sleep apnea and subsequently underwent adenotonsillectomy between December 1, 2000, and November 30, 2003, were included in the study. The PSGs were analyzed for data on the respiratory disturbance index (RDI), time spent in each body position, number of apneic events in each position, oxygen saturation, and time spent in each stage of sleep. The results determined the statistical significance of these parameters.
Sixty patients satisfied the criteria for inclusion in the study. The mean supine sleep RDI was 8.5 compared with 4.9 for the mean nonsupine sleep RDI. The mean RDI increased from 5.6 to 8.5 when more than 50% of the time was spent in supine sleep. There was a further increase to 10.5 when supine sleep increased to 75% of the total sleep time. The mean RDI in rapid eye movement sleep was 20.5 compared with 5.3 in non-rapid eye movement sleep. The mean +/- SD supine sleep RDI was 18.5 +/- 5.1, and the mean nonsupine RDI was 7.2 +/- 1.9, which was statistically significant (P = .02).
There is an increase in the RDI with increased time spent in supine sleep in very young children with obstructive sleep apnea. Inadequate time spent in that position may lead to an underestimation of the severity of obstructive sleep apnea. A combination of reduced rapid eye movement sleep and increased nonsupine sleep may invalidate the findings of PSG in these children.
通过多导睡眠图（PSG）确定患有阻塞性睡眠呼吸暂停综合征的幼儿（年龄≤3岁）睡眠期间体位与阻塞性事件之间的关联。
回顾性病历审查。
纳入2000年12月1日至2003年11月30日期间接受PSG评估阻塞性睡眠呼吸暂停并随后接受腺样体扁桃体切除术的3岁及以下儿童。对PSG数据进行分析，包括呼吸紊乱指数（RDI）、每个体位的停留时间、每个体位的呼吸暂停事件数量、血氧饱和度以及每个睡眠阶段的停留时间。结果确定了这些参数的统计学意义。
60名患者符合纳入研究的标准。仰卧睡眠时的平均RDI为8.5，而非仰卧睡眠时的平均RDI为4.9。当超过50%的时间处于仰卧睡眠时，平均RDI从5.6增加到8.5。当仰卧睡眠增加到总睡眠时间的75%时，平均RDI进一步增加到10.5。快速眼动睡眠时的平均RDI为20.5，而非快速眼动睡眠时为5.3。仰卧睡眠时的平均±标准差RDI为18.5±5.1，非仰卧RDI为7.2±1.9，具有统计学意义（P = 0.02）。
患有阻塞性睡眠呼吸暂停的幼儿仰卧睡眠时间增加会导致RDI升高。该体位停留时间不足可能导致对阻塞性睡眠呼吸暂停严重程度的低估。快速眼动睡眠减少和非仰卧睡眠增加相结合可能会使这些儿童的PSG检查结果无效。
