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[儿童和青少年睡眠障碍,特别提及过敏性疾病]

[Sleep disorders in childhood and adolescence, with special reference to allergic diseases].

作者信息

Wasilewska Jolanta, Kaczmarski Maciej, Protas Piotr T, Kowalczuk-Krystoń Monika, Mazan Barbara, Topczewska Magdalena

机构信息

Department of Pediatrics, Gastroenterology and Allergic Diseases, Medical University of Bialystok, Poland.

出版信息

Pol Merkur Lekarski. 2009 Mar;26(153):188-93.

Abstract

UNLABELLED

Allergic diseases have a significant impact on the quality of life. The aim of the study was to compare sleep parameters of allergic and non-allergic children.

MATERIAL AND METHODS

Pediatric Sleep Questionnaire was used to asses sleep quality in 202 participants in a 3-year prospective study: in 122 hospitalized (mean age 7.9 +/- 4.7) (F/M 75/47) due to allergic (n = 70) or non-allergic disease (n = 52), and in 80 healthy children (mean age 6.3 +/- 5.0) (F/M 36/44). Of 70 allergic participants, 26 had atopic dermatitis (SCORAD > or = 20); 25 were with bronchial asthma (GINA' criteria) and 19 with IgE-dependent food allergy confirmed by oral food challenge. Of 52 non-allergic patients, 31 children had gastro-esophageal reflux disease and 21 children had recurrent respiratory infection.

RESULTS

The group of patients needed significantly more time to fall asleep than controls (17.9 +/- 13.7 vs 12.8 +/- 8.5 min; p < 0.004). Children with food allergy and atopic dermatitis had greatest problems with falling asleep (21.4 +/- 13.8 vs 12.8 +/- 8.5 min; p < 0.006) and 20.4 +/- 14.9 vs 12.8 +/- 8.5 min; p < 0.024). The number of nights of sound sleep without waking up was lower in the study group than in controls (3.5 +/- 2.6 vs 5.0 +/- 2.7; p < 0.0002). Atopic dermatitis and food allergy were found to predispose to sleep disruption most. Snoring history was revealed in 43.4% of patients and in 6.4% of controls (p < 0.0001), being significantly more common in children with bronchial asthma and recurrent respiratory tract infections. Allergic disease was a risk factor for snoring (OR--2.94; 95%CI--1.72-5.05; p < 0.001). As many as 91% of parents did not inform doctors about poor sleep of their children.

CONCLUSIONS

  1. Allergic diseases are accompanied by different sleep disorders included dyssomnias and parasomnias, e.g. bedtime resistance, disrupted sleep or sleep-disordered breathing. 2. Physicians should pay particular attention to sleep quality in children with allergic diseases irrespective of which body system is affected i.e. the skin (atopic dermatitis), the respiratory tract (bronchial asthma) or the alimentary system (food allergy).
摘要

未标注

过敏性疾病对生活质量有重大影响。本研究的目的是比较过敏和非过敏儿童的睡眠参数。

材料与方法

在一项为期3年的前瞻性研究中,使用儿童睡眠问卷评估202名参与者的睡眠质量:122名住院儿童(平均年龄7.9±4.7岁)(男/女75/47),其中因过敏性疾病(n = 70)或非过敏性疾病(n = 52)住院,以及80名健康儿童(平均年龄6.3±5.0岁)(男/女36/44)。在70名过敏参与者中,26名患有特应性皮炎(SCORAD≥20);25名患有支气管哮喘(符合GINA标准),19名经口服食物激发试验确诊为IgE依赖型食物过敏。在52名非过敏患者中,31名儿童患有胃食管反流病,21名儿童患有反复呼吸道感染。

结果

患者组入睡所需时间明显比对照组多(17.9±13.7分钟对12.8±8.5分钟;p < 0.004)。食物过敏和特应性皮炎患儿入睡困难问题最大(21.4±13.8分钟对12.8±8.5分钟;p < 0.006)以及20.4±14.9分钟对12.8±8.5分钟;p < 0.024)。研究组无觉醒的安稳睡眠夜数比对照组少(3.5±2.6对5.0±2.7;p < 0.0002)。发现特应性皮炎和食物过敏最易导致睡眠中断。43.4%的患者有打鼾史,而对照组为6.4%(p < 0.0001),在支气管哮喘和反复呼吸道感染患儿中更常见。过敏性疾病是打鼾的危险因素(比值比——2.94;95%置信区间——1.72 - 5.05;p < 0.001)。多达91%的家长未告知医生其孩子睡眠不佳的情况。

结论

  1. 过敏性疾病伴有不同的睡眠障碍,包括失眠症和异态睡眠,如就寝时间抗拒、睡眠中断或睡眠呼吸障碍。2. 医生应特别关注患有过敏性疾病儿童的睡眠质量,无论受影响的是哪个身体系统,即皮肤(特应性皮炎)、呼吸道(支气管哮喘)或消化系统(食物过敏)。

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