Zhang Xiao-Wen, Zhou Feng, Li Yuan, Huang Zhao-Tong, Wang Zhen-Lin
Department of Otolaryngology - Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
J Paediatr Child Health. 2006 Oct;42(10):625-9. doi: 10.1111/j.1440-1754.2006.00939.x.
Adenoidal hypertrophy (AH) in children is associated with obstructive manifestations like mouth breathing, snoring. Unfortunately, little is known regarding sleep architecture of AH in children. The purpose of this study was therefore undertaken to investigate the polysomnographic variables in children with AH.
47 children with AH and 11 controls underwent nocturnal polysomnography. Sleep was scored manually according to the standard set by Rechtschaffen.
In AH, stage 1 sleep percentage and rapid eye movement (REM) latency were increased significantly, while the sleep percentage of stage 2 and REM was decreased remarkably compared with that of controls. Arousal index in AH was much more higher than that in controls. Arousal index in REM sleep was higher than that in non-rapid eye movement (NREM) sleep in AH, but the number of arousals in REM sleep was lower than that in NREM sleep. Hypopnea events were the most common type of respiratory events, followed by obstructive events in AH and controls. Apnea/hypopnea index in AH was higher in comparison to controls. No significant difference was found between the children with AH and controls in SaO(2) nadir (%) and base mean SaO(2) (%). Apnea/hypopnea index was related to hypopnea arousal in REM sleep and hypoxemia arousal in NREM sleep.
AH is predominantly characterised by a hypopnea with little obstruction in children. Our results clearly and for the first time demonstrated that sleep architecture was abnormal in children with AH. We therefore speculate that hypopnea arousal in REM sleep and hypoxemia arousal in NREM sleep may play an important role in the course of respiratory disturbance.
儿童腺样体肥大（AH）与诸如口呼吸、打鼾等阻塞性表现相关。遗憾的是，关于儿童腺样体肥大患者的睡眠结构知之甚少。因此，本研究旨在调查腺样体肥大患儿的多导睡眠图变量。
47例腺样体肥大患儿和11例对照者接受夜间多导睡眠监测。根据 Rechtschaffen 制定的标准对睡眠进行人工评分。
与对照组相比，腺样体肥大患儿的1期睡眠百分比和快速眼动（REM）潜伏期显著增加，而2期睡眠和REM睡眠百分比显著降低。腺样体肥大患儿的觉醒指数远高于对照组。腺样体肥大患儿REM睡眠中的觉醒指数高于非快速眼动（NREM）睡眠，但REM睡眠中的觉醒次数低于NREM睡眠。低通气事件是最常见的呼吸事件类型，腺样体肥大患儿和对照组其次是阻塞性事件。腺样体肥大患儿的呼吸暂停/低通气指数高于对照组。腺样体肥大患儿与对照组在最低血氧饱和度（%）和平均基础血氧饱和度（%）方面无显著差异。呼吸暂停/低通气指数与REM睡眠中的低通气觉醒和NREM睡眠中的低氧血症觉醒有关。
腺样体肥大在儿童中主要表现为低通气且阻塞程度较轻。我们的结果首次明确表明腺样体肥大患儿的睡眠结构异常。因此，我们推测REM睡眠中的低通气觉醒和NREM睡眠中的低氧血症觉醒可能在呼吸紊乱过程中起重要作用。
