Pediatric Sleep Center, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sleep Med. 2013 Oct;14(10):991-4. doi: 10.1016/j.sleep.2013.03.026. Epub 2013 Jul 25.
Sleep-disordered breathing (SDB) is a common disorder associated with substantial morbidity that occurs in otherwise healthy children. Atopy, asthma, and viral upper respiratory tract infections are known risk factors for pediatric SDB that exhibit seasonal variability. The aim of our study was to investigate the effect of seasonality on SDB severity in children and adolescents referred for polysomnographic evaluation for suspected SDB and to examine the effect of atopy/asthma on this variability.
The medical records of all children and adolescents referred for a polysomnography (PSG) for suspected SDB between 2008 and 2010 were retrospectively assessed for seasonal patterns. The effect of atopy/asthma, age, and obesity on seasonal variability was investigated.
A total of 2178 children and adolescents (65% boys) were included. The mean age of the cohort was 4.9±3.5 years (range, 3 months-18 years). Eighteen percent of patients had a history of asthma/atopy. The mean obstructive apnea-hypopnea index (OAHI) in the winter was significantly higher compared to the summer (9.1±9.6 vs. 7.5±7.0; P=.01; Cohen d=0.19), particularly in children younger than the age of 5 years (10.2±10.5 vs. 7.9±7.3; P=.008; Cohen d=0.25). Asthma/atopy had no significant effect on seasonal variability.
SDB severity alters in a season-dependent manner in children and adolescents referred for polysomnographic evaluation for suspected SDB. These alterations are more prominent in children younger than the age of 5 years. The presence of asthma/atopy does not contribute to this seasonal variability. These findings suggest that viral respiratory infections are most likely the major contributor for the seasonal variability observed in pediatric SDB; additionally, the time of the year when a child is evaluated for suspected SDB may affect the clinical management and outcome in borderline cases.
睡眠呼吸障碍（SDB）是一种常见的疾病，与相当多的发病率相关，发生在健康的儿童中。特应性、哮喘和病毒上呼吸道感染是儿科 SDB 的已知危险因素，其表现出季节性可变性。本研究的目的是调查季节性变化对因疑似 SDB 进行多导睡眠图（PSG）评估的儿童和青少年 SDB 严重程度的影响，并研究特应性/哮喘对这种可变性的影响。
回顾性评估了 2008 年至 2010 年间因疑似 SDB 而进行 PSG 的所有儿童和青少年的病历，以评估季节性模式。研究了特应性/哮喘、年龄和肥胖对季节性变化的影响。
共纳入 2178 名儿童和青少年（65%为男孩）。队列的平均年龄为 4.9±3.5 岁（范围，3 个月至 18 岁）。18%的患者有哮喘/特应性病史。冬季的平均阻塞性呼吸暂停低通气指数（OAHI）显著高于夏季（9.1±9.6 比 7.5±7.0；P=.01；Cohen d=0.19），尤其是年龄小于 5 岁的儿童（10.2±10.5 比 7.9±7.3；P=.008；Cohen d=0.25）。哮喘/特应性对季节性变化无显著影响。
因疑似 SDB 而接受 PSG 评估的儿童和青少年的 SDB 严重程度呈季节性变化。这些变化在年龄小于 5 岁的儿童中更为明显。哮喘/特应性的存在并不导致这种季节性变化。这些发现表明，病毒呼吸道感染很可能是儿科 SDB 观察到的季节性变化的主要原因；此外，评估疑似 SDB 的儿童的时间可能会影响临界病例的临床管理和结果。
