Mitki Tali, Pillar Giora
The Family Medicine Department, Emek Medical Center, North District.
Harefuah. 2009 May;148(5):300-3, 351.
Sleep apnea syndrome (SAS] is common in both adults and children (amongst whom it is estimated at 2-3%). This syndrome significantly affects the child's daily activities and development. Research in adults has demonstrated a direct relationship between sleeping supine and the severity of sleep apnea syndrome. Very few studies were conducted among children and the findings were controversial.
The goal of this study was to continue examining and establishing the relationship between children's sleep position and the severity of sleep apnea syndrome.
The study group consisted of 25 children with cLinically suspected obstructive sleep apnea [OSA), referred to the Technion's Sleep Lab for confirmation of this diagnosis. The study course included nocturnal recording of the children and closely monitoring their sleep position. Data analysis included a comparison of the various data regarding the severity of the children's respiratory disturbance, at each stage of sleep and in each sleeping position separately. Analysis of the results was performed using the paired T test.
Sixteen boys and 9 girls aged 5.5 years (range 2-12 years) with various severity of OSA, most of them with moderate-severe degree of sleep apnea, [average respiratory disturbance index of 14.7 +/- 12.3/h) were studied. In most children the recording consisted of all sleep postures, but no statistically significant relationship was found between the various sleeping positions and the severity of OSA, neither in REM sleep nor in NREM sleep.
We believe that the absence of positional effect in children with moderate-severe obstructive sleep apnea syndrome results from a different mechanism and site of obstruction. While in adults the Location of obstruction is mostly retroglossal or retropalatal, in children it is usually at the levels of tonsils and adenoids.
睡眠呼吸暂停综合征（SAS）在成人和儿童中都很常见（据估计在儿童中的发病率为2%-3%）。这种综合征会显著影响儿童的日常活动和发育。针对成人的研究表明仰卧睡眠与睡眠呼吸暂停综合征的严重程度之间存在直接关系。针对儿童的研究很少，且结果存在争议。
本研究的目的是继续研究并确定儿童睡眠姿势与睡眠呼吸暂停综合征严重程度之间的关系。
研究组由25名临床疑似阻塞性睡眠呼吸暂停（OSA）的儿童组成，他们被转诊至以色列理工学院睡眠实验室以确诊。研究过程包括对儿童进行夜间记录，并密切监测他们的睡眠姿势。数据分析包括分别比较儿童在每个睡眠阶段和每个睡眠姿势下呼吸紊乱严重程度的各种数据。使用配对t检验进行结果分析。
研究了16名男孩和9名女孩，年龄5.5岁（范围2-12岁），患有不同严重程度的OSA，其中大多数为中度至重度睡眠呼吸暂停（平均呼吸紊乱指数为14.7±12.3/小时）。大多数儿童的记录包括所有睡眠姿势，但在快速眼动睡眠和非快速眼动睡眠中，不同睡眠姿势与OSA严重程度之间均未发现统计学上的显著关系。
我们认为，中度至重度阻塞性睡眠呼吸暂停综合征儿童不存在体位效应是由不同的阻塞机制和部位导致的。成人的阻塞部位大多在舌后或腭后，而儿童通常在扁桃体和腺样体水平。
