Hill Catherine M, Parker Rachel C, Allen Penny, Paul Annette, Padoa Kathryn A
Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK.
Acta Paediatr. 2009 Nov;98(11):1809-14. doi: 10.1111/j.1651-2227.2009.01441.x. Epub 2009 Jul 22.
Night-time postural equipment (NTPE) prevents contractures and hip subluxation in children with severe physical disabilities. However, impact on sleep quality and respiratory function has not been objectively studied.
Ten children with severe cerebral palsy (CP), mean age of 10.9 (range: 5.3-16.7) years, were recruited from a community population. Polysomnography was undertaken on two nights, once with the child sleeping in their NTPE and once sleeping unsupported. Randomization to first night condition controlled for first night effects.
Night-time postural equipment use was associated with higher mean overnight oxygen saturation for three children but lower values for six children compared with sleeping unsupported. There were no differences in sleep quality between the conditions. The study group had lower overnight oxyhaemoglobin saturation values, less rapid eye movement (REM) sleep and higher arousal indices compared with typically developing children.
This pilot study indicated that children with severe CP risk respiratory compromise in sleep irrespective of positioning. Further study will determine if the observed trend for mean overnight oxygen saturation to be lower within positioning equipment reflects random night-to-night variation or is related to equipment use. We suggest that respiratory function is assessed when determining optimal positioning for children using night-time positioning equipment.
夜间体位设备（NTPE）可预防重度身体残疾儿童的挛缩和髋关节半脱位。然而，其对睡眠质量和呼吸功能的影响尚未得到客观研究。
从社区人群中招募了10名重度脑瘫（CP）儿童，平均年龄10.9岁（范围：5.3 - 16.7岁）。在两个晚上进行多导睡眠图监测，一次让儿童戴着NTPE睡觉，一次不使用支撑物睡觉。随机安排第一晚的情况以控制首夜效应。
与不使用支撑物睡觉相比，使用夜间体位设备时，3名儿童的夜间平均血氧饱和度较高，而6名儿童的夜间平均血氧饱和度较低。两种情况下睡眠质量无差异。与正常发育儿童相比，研究组的夜间氧合血红蛋白饱和度值较低，快速眼动（REM）睡眠较少，觉醒指数较高。
这项初步研究表明，重度脑瘫儿童无论处于何种体位，睡眠时都有呼吸功能受损的风险。进一步的研究将确定在体位设备中观察到的夜间平均血氧饱和度较低的趋势是反映了夜间随机变化还是与设备使用有关。我们建议在为使用夜间体位设备的儿童确定最佳体位时评估呼吸功能。
