Integrative Physiology of Brain Arousal System, CRNL, University Lyon 1, Lyon, France.
CNS Neurosci Ther. 2013 Jul;19(7):521-8. doi: 10.1111/cns.12105. Epub 2013 Apr 10.
To evaluate the impact of obesity on clinical and sleep characteristics in a population of narcoleptic children.
Data from the children diagnosed with idiopathic narcolepsy in the National Reference Centers for Narcolepsy were collected between 2008 and 2011. Clinical and electrophysiological characteristics were compared between obese (body mass index [BMI] greater than P97) and nonobese children.
The 117 children (65 boys, 59 de novo patients) had a mean age of 11.6 ± 3.1 years on diagnosis. Cataplexy was present in 81%, DQB1*0602 in 91%. Mean BMI was 23.2 ± 5.2 kg/m(2) and BMI z-score was 2.9 ± 2.6. Obesity was found in 60% with a similar prevalence in treated versus de novo patients and in patients with and without cataplexy. Sleepiness and cataplexy started earlier in obese children. Obese narcoleptic children had lower sleep efficiency, higher apnea hypopnea index and respiratory arousals index (RAI) than nonobese children. BMI z-score was positively correlated with RAI. Obese children were more tired and missed more often school than nonobese children.
Obesity affects more than 50% of narcoleptic children, mostly younger at disease onset, and has a deleterious impact on sleep quality as well as on school attendance.
评估肥胖对发作性睡病儿童临床和睡眠特征的影响。
收集了 2008 年至 2011 年间在国家发作性睡病参考中心诊断为特发性发作性睡病的儿童的数据。比较了肥胖（体重指数[BMI]大于 P97）和非肥胖儿童的临床和电生理特征。
117 名儿童（65 名男孩，59 名首发患者）诊断时的平均年龄为 11.6 ± 3.1 岁。81%存在猝倒，91%存在 DQB1*0602。平均 BMI 为 23.2 ± 5.2 kg/m(2)，BMI z 评分 2.9 ± 2.6。肥胖的比例为 60%，在治疗组和首发组、有猝倒和无猝倒的患者中，肥胖的比例相似。肥胖的发作性睡病儿童更易出现嗜睡和猝倒。肥胖的发作性睡病儿童睡眠效率较低，呼吸暂停低通气指数和呼吸觉醒指数（RAI）较高。BMI z 评分与 RAI 呈正相关。肥胖儿童比非肥胖儿童更疲倦，更常缺课。
肥胖影响了超过 50%的发作性睡病儿童，他们大多数在疾病发病时更年轻，肥胖对睡眠质量和上学出勤率都有不良影响。
