Kim Hyo Yeol, Dhong Hun-Jong, Lee Jae-Kwon, Chung Seung-Kyu, Jung Soo-Chan
Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Auris Nasus Larynx. 2011 Apr;38(2):228-32. doi: 10.1016/j.anl.2010.07.005. Epub 2010 Aug 30.
To assess whether obstructive sleep apnea syndrome (OSAS) affects sleep architecture and quality in East Asian children, and also to assess the effects of body position during sleep on respiratory disturbance during sleep.
We enrolled 50 consecutive East Asian children with habitual snoring between 2007 and 2009. Nineteen children had OSAS (apnea-hypopnea index, AHI≥5; OSAS group) and 31 children were simple snorers (control group). They underwent polysomnography and physical examination of their nasal and oral cavities with a roentgenogram of the nasopharynx. Sleep architecture and other polysomnographic variables were compared between the OSAS and control groups. The effect of body position during sleep on respiratory disturbance was examined, and also in relation to obesity and adeno-tonsillar size.
There was a decrease in total sleep time and in sleep efficiency, as well as increased arousal and heart rate (P<0.05) in the OSAS group. Sub-analysis of AHI according to sleep posture showed that AHI is higher when the patient is in the supine position than in the non-supine position (P=0.032). The presence of OSAS and kissing tonsils were contributing factors to the positional difference in AHI (P<0.05). Obesity and adenoid hypertrophy did not affect the positional difference of AHI.
OSAS may have a greater influence on the sleep architecture of East Asian children, and East Asian children may have a higher AHI when sleeping in the supine position. Tonsillar hypertrophy and the presence of OSAS are possible contributing factors for positional difference of AHI in East Asian children.
评估阻塞性睡眠呼吸暂停综合征（OSAS）是否影响东亚儿童的睡眠结构和质量，以及睡眠时体位对睡眠期间呼吸紊乱的影响。
我们纳入了2007年至2009年间连续50名有习惯性打鼾的东亚儿童。19名儿童患有OSAS（呼吸暂停低通气指数，AHI≥5；OSAS组），31名儿童为单纯打鼾者（对照组）。他们接受了多导睡眠图检查以及鼻腔和口腔的体格检查，并拍摄了鼻咽部X线片。比较了OSAS组和对照组的睡眠结构及其他多导睡眠图变量。研究了睡眠时体位对呼吸紊乱的影响，并分析了其与肥胖及腺样体扁桃体大小的关系。
OSAS组的总睡眠时间和睡眠效率降低，觉醒和心率增加（P<0.05）。根据睡眠姿势对AHI进行的亚组分析显示，患者仰卧位时的AHI高于非仰卧位（P=0.032）。OSAS的存在和亲吻扁桃体是AHI体位差异的影响因素（P<0.05）。肥胖和腺样体肥大不影响AHI的体位差异。
OSAS可能对东亚儿童的睡眠结构有更大影响，且东亚儿童仰卧位睡眠时可能有更高的AHI。扁桃体肥大和OSAS的存在可能是东亚儿童AHI体位差异的影响因素。
