Shott Sally R, Amin Raouf, Chini Barbara, Heubi Christine, Hotze Stephanie, Akers Rachel
Department of Otolaryngology/Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA.
Arch Otolaryngol Head Neck Surg. 2006 Apr;132(4):432-6. doi: 10.1001/archotol.132.4.432.
To determine the incidence of obstructive sleep apnea syndrome in children aged 2 to 4 years with Down syndrome and to determine parents' ability to predict sleep abnormalities in this patient population.
Prospective cohort study.
Tertiary care pediatric referral center.
Sixty-five children participating in a 5-year longitudinal study in which the otolaryngologic problems seen in Down syndrome were evaluated. Fifty-six completed overnight polysomnography (PSG) between 4 and 63 months of age (mean age, 42 months).
Overnight PSG was performed. Parents also completed a questionnaire regarding their impressions of their child's sleep patterns before PSG.
Polysomnograms were classified as abnormal if the obstructive index was greater than 1, if the carbon dioxide level was greater than 45 mm Hg for more than two thirds of the study or greater than 50 mm Hg for more than 10% of the study, and/or if there was unexpected hypoxemia less than 92% during sleep or repeated intermittent desaturations less than 90%. We also identified a group of children whose PSGs findings were normal except for an arousal index greater than 10 and were associated with increased work of breathing.
The PSGs revealed that 57% of the children had abnormal results and evidence of obstructive sleep apnea syndrome. If we also include an elevated arousal index, 80% of the PSGs had abnormal results. Sixty-nine percent of parents reported no sleep problems in their children, but in this group, 54% of PSGs had abnormal results. Of the parents who reported sleep problems in their children, only 36% had abnormal sleep study results.
Because of the high incidence of obstructive sleep apnea syndrome in young children with Down syndrome, and the poor correlation between parental impressions of sleep problems and PSG results, baseline PSG is recommended in all children with Down syndrome at age 3 to 4 years.
确定2至4岁唐氏综合征患儿阻塞性睡眠呼吸暂停综合征的发病率，并确定家长预测该患者群体睡眠异常的能力。
前瞻性队列研究。
三级医疗儿科转诊中心。
65名儿童参与了一项为期5年的纵向研究，该研究对唐氏综合征患儿出现的耳鼻喉问题进行了评估。其中56名儿童在4至63个月大（平均年龄42个月）时完成了夜间多导睡眠图（PSG）检查。
进行夜间PSG检查。家长们还在PSG检查前完成了一份关于他们对孩子睡眠模式印象的问卷。
如果阻塞指数大于1、如果在超过三分之二的研究中二氧化碳水平大于45毫米汞柱或在超过10%的研究中大于50毫米汞柱，和/或如果在睡眠期间出现低于92%的意外低氧血症或低于90%的反复间歇性血氧饱和度下降，则多导睡眠图被分类为异常。我们还确定了一组儿童，他们的PSG检查结果除了觉醒指数大于10外均正常，且与呼吸功增加有关。
PSG检查显示，57%的儿童结果异常并有阻塞性睡眠呼吸暂停综合征的证据。如果我们还包括升高的觉醒指数，80%的PSG检查结果异常。69%的家长报告他们的孩子没有睡眠问题，但在这组中，54%的PSG检查结果异常。在报告孩子有睡眠问题的家长中，只有36%的睡眠研究结果异常。
由于唐氏综合征幼儿阻塞性睡眠呼吸暂停综合征的发病率很高，且家长对睡眠问题的印象与PSG检查结果之间的相关性较差，建议对所有3至4岁的唐氏综合征儿童进行基线PSG检查。
