Alves Rosana S C, Resende Maria B D, Skomro Robert P, Souza Fabio J F B, Reed Umbertina C
Department of Neurology, University of São Paulo Medical School, HC-FMUSP, São Paulo, SP, Brazil.
Sleep Med Rev. 2009 Apr;13(2):133-48. doi: 10.1016/j.smrv.2008.02.002. Epub 2008 Jun 4.
Children suffering from neuromuscular diseases are at an increased risk of sleep-related breathing disorders (SRBD) such as obstructive sleep apnea syndrome (OSAS) and hypoventilation as well as central sleep apnea, which is frequent in these patients due to diaphragmatic weakness. They are at higher risk for developing complications of nocturnal hypoxemia, including pulmonary hypertension, cor pulmonale and neurocognitive dysfunction. Neuromuscular disorders and OSAS are both prevalent disorders and frequently overlap. Sleep-related hypoventilation/hypoxemia due to neuromuscular diseases may be exacerbated in the presence of OSAS; these children are likely to experience greater severity and duration of sleep-related hypoxemia than are children with either disorder alone. Additionally, some of these children have reduced central neural chemoresponsiveness. The development of SRBD in these patients further impairs their quality of life and worsens their respiratory status. We review the literature on the diagnosis and treatment of SRBD in children with a variety of neuromuscular disorders.
患有神经肌肉疾病的儿童出现与睡眠相关的呼吸障碍（SRBD）的风险增加，如阻塞性睡眠呼吸暂停综合征（OSAS）、通气不足以及中枢性睡眠呼吸暂停，由于膈肌无力，中枢性睡眠呼吸暂停在这些患者中很常见。他们发生夜间低氧血症并发症的风险更高，包括肺动脉高压、肺心病和神经认知功能障碍。神经肌肉疾病和OSAS都是常见疾病，且经常重叠。神经肌肉疾病导致的与睡眠相关的通气不足/低氧血症在存在OSAS时可能会加重；与仅患其中一种疾病的儿童相比，这些儿童可能会经历更严重、持续时间更长的与睡眠相关的低氧血症。此外，这些儿童中的一些人中枢神经化学反应性降低。这些患者中SRBD的发生进一步损害了他们的生活质量，并使他们的呼吸状况恶化。我们综述了有关各种神经肌肉疾病儿童SRBD诊断和治疗的文献。
