Goldstein Nira A, Keller Roni, Rey Kathy, Rao Sreedhar, Weedon Jeremy, Dastgir Ghulam, Mironov Alexander, Miller Scott T
Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
Arch Otolaryngol Head Neck Surg. 2011 Dec;137(12):1263-8. doi: 10.1001/archoto.2011.190.
To determine the prevalence of sleep-disordered breathing in children with sickle cell disease and whether there is an association of sleep-disordered breathing with high-risk transcranial Doppler ultrasonography (TCD) velocities. Study
Cross-sectional.
Tertiary care academic medical center.
Sixty-four children (aged 2-14 years) selected for eligible genotype (type SS or Sβ(0)-thalassemia) and no history of stroke.
Parents completed the Pediatric Sleep Questionnaire. Overnight polysomnography was performed for children with snoring. The TCD was performed or existing results were obtained for all children; for children who underwent transfusion therapy, readings prior to the transfusion were analyzed. Children with abnormal or conditional TCD (flow velocity ≥170 cm/s in any vessel) were considered high risk.
Prevalence of sleep-disordered breathing and TCD velocity and frequency of high-risk TCD in patients with and without sleep-disordered breathing.
The prevalence of snoring was 37.5% (95% CI, 26.7%-49.8%), the prevalence of positive polysomnography findings was 23.7% (14.6%-36.1%), and the prevalence of positive Pediatric Sleep Questionnaire scores was 21.9% (13.4%-33.6%). There was no significant difference in TCD velocity or number of patients with high-risk TCD between nonsnorers and children with snoring but negative polysomnography findings and children with snoring and positive polysomnography findings (P = .91 and P = .66, respectively) or between nonsnorers and snorers with a negative Pediatric Sleep Questionnaire score and snorers with a positive Pediatric Sleep Questionnaire score (P = .76 and P = .33, respectively).
There is a high prevalence of snoring and sleep-disordered breathing among children with sickle cell disease, but our results do not support an association with cerebrovascular risk.
确定镰状细胞病患儿睡眠呼吸障碍的患病率，以及睡眠呼吸障碍与高风险经颅多普勒超声（TCD）速度之间是否存在关联。
横断面研究。
三级医疗学术医学中心。
64名年龄在2至14岁之间、基因型符合条件（SS型或Sβ(0) -地中海贫血型）且无中风病史的儿童。
家长完成儿童睡眠问卷。对打鼾儿童进行整夜多导睡眠监测。对所有儿童进行TCD检查或获取现有结果；对于接受输血治疗的儿童，分析输血前的检查结果。TCD异常或有条件异常（任何血管流速≥170 cm/s）的儿童被视为高风险。
有和无睡眠呼吸障碍患者的睡眠呼吸障碍患病率、TCD速度以及高风险TCD的频率。
打鼾患病率为37.5%（95%CI，26.7%-49.8%），多导睡眠监测阳性结果患病率为23.7%（14.6%-36.1%），儿童睡眠问卷阳性评分患病率为21.9%（13.4%-33.6%）。在不打鼾者与打鼾但多导睡眠监测结果为阴性的儿童以及打鼾且多导睡眠监测结果为阳性的儿童之间，TCD速度或高风险TCD患者数量无显著差异（分别为P = 0.91和P = 0.66）；在不打鼾者与儿童睡眠问卷评分阴性的打鼾者以及儿童睡眠问卷评分阳性的打鼾者之间也无显著差异（分别为P = 0.76和P = 0.33）。
镰状细胞病患儿中打鼾和睡眠呼吸障碍的患病率较高，但我们的结果不支持其与脑血管风险存在关联。
