Gao Juan, Zhang Ya-mei, Liu Shi-lin, Zhang Jie, An Jia-qing
Department of Otorhinolaryngology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Sep;45(9):742-6.
Abnormal breathing during sleep included many patterns. In this study, we investigated paradoxical breathing patterns during sleep in children using standard polysomnography (PSG).
Children who come to the ENT because of snoring were included into the study consecutively. Those who had craniofacial anomalies, diabetes, chronic lung diseases, and neuromuscular diseases were excluded. At the same time, no sleep snoring children were include as controls. Thirty-eight snoring children and twenty-six no snoring children were recruited. Polysomnography (PSG) was performed on all subjects. We determined the frequency of paradoxical breathing patterns during sleep through blind analysis of polysomnograms obtained in all subjects and compared the difference between children with snoring and normal controls.
The appearance of paradoxical breathing was assessed in all subjects. Among children with snoring, the apparent amount of paradoxical breathing time and the percent of paradoxical breathing time spent in total sleep time (x(-) ± s) were (70.1 ± 40.4) min and 17.9% ± 11.0% respectively. Comparing with control group (28.2 ± 25.7) min and 7.3% ± 6.8%, there was obvious difference (paradoxical breathing time t = 5.060, percent of paradoxical breathing time t = 4.767, P < 0.05). Thirty-eight snoring children were divided into normal-mild group (eighteen children) and moderate-severe group (twenty children). The children whose PSG results were normal and mild had more paradoxical breathing time and the percent of paradoxical breathing time than moderate-severe group. The apparent amount of paradoxical breathing time of normal-mild group, moderate-severe group and control group were (85.9 ± 31.7) min, (55.8 ± 42.7) min and (28.2 ± 25.7) min. Among the three groups, there was obvious difference (F = 15.897, P < 0.05). The percent of paradoxical breathing time of the three groups were 22.0% ± 10.2%, 14.1% ± 10.5% and 7.3% ± 6.8% (F = 14.167, P < 0.05).
Currently published polysomnographic scoring recommendations overlook some common breathing abnormalities during sleep that are associated with clinical complaints. Paradoxical breathing is abnormal breathing patterns during sleep and its appearance is used to aid in the identification of respiratory events.
睡眠期间的异常呼吸包括多种模式。在本研究中，我们使用标准多导睡眠图（PSG）对儿童睡眠期间的矛盾呼吸模式进行了调查。
因打鼾前来耳鼻喉科就诊的儿童被连续纳入研究。排除患有颅面畸形、糖尿病、慢性肺部疾病和神经肌肉疾病的儿童。同时，纳入无睡眠打鼾的儿童作为对照。招募了38名打鼾儿童和26名无打鼾儿童。对所有受试者进行多导睡眠图（PSG）检查。通过对所有受试者获得的多导睡眠图进行盲法分析，确定睡眠期间矛盾呼吸模式的频率，并比较打鼾儿童与正常对照组之间的差异。
对所有受试者的矛盾呼吸出现情况进行了评估。在打鼾儿童中，矛盾呼吸时间的表观量和占总睡眠时间的百分比（x(-)±s）分别为（70.1±40.4）分钟和17.9%±11.0%。与对照组（28.2±25.7）分钟和7.3%±6.8%相比，存在明显差异（矛盾呼吸时间t = 5.060，矛盾呼吸时间百分比t = 4.767，P < 0.05）。38名打鼾儿童分为正常-轻度组（18名儿童）和中度-重度组（20名儿童）。PSG结果为正常和轻度的儿童比中度-重度组有更多的矛盾呼吸时间和矛盾呼吸时间百分比。正常-轻度组、中度-重度组和对照组的矛盾呼吸时间表观量分别为（85.9±31.7）分钟、（55.8±42.7）分钟和（28.2±25.7）分钟。三组之间存在明显差异（F = 15.897，P < 0.05）。三组的矛盾呼吸时间百分比分别为22.0%±10.2%、14.1%±10.5%和7.3%±6.8%（F = 14.167，P < 0.05）。
目前发表的多导睡眠图评分建议忽略了一些与临床症状相关的常见睡眠期间呼吸异常。矛盾呼吸是睡眠期间的异常呼吸模式，其出现有助于识别呼吸事件。
