Sleep Center, The Children's Hospital of Philadelphia, PA, USA.
Paediatr Respir Rev. 2013 Sep;14(3):199-203. doi: 10.1016/j.prrv.2012.05.006. Epub 2012 Jun 26.
The obstructive sleep apnea syndrome is common and its prevalence is expected to increase with the current obesity epidemic. If left untreated, it is associated with important morbidity such as growth failure, neurocognitive impairment, systemic and pulmonary hypertension, and endothelial dysfunction. Recent research has shown that many children, especially the obese or those with other underlying medical conditions, have residual obstructive sleep apnea after adenotonsillectomy (the primary treatment for childhood obstructive sleep apnea). These children could be effectively treated with continuous positive airway pressure but poor adherence is a significant limitation of this therapy. Therefore, new treatment modalities for the pediatric obstructive sleep apnea syndrome are needed. Current research has focused on newer therapies for pediatric obstructive sleep apnea, such as anti-inflammatories, dental treatments, high-flow nasal cannula, and weight loss. However, there are few randomized controlled trials assessing the effectiveness of these therapies. Further research is warranted.
阻塞性睡眠呼吸暂停综合征很常见,预计随着当前肥胖症的流行,其患病率将会增加。如果不进行治疗,它与重要的发病率相关,如生长障碍、神经认知障碍、全身和肺高血压以及内皮功能障碍。最近的研究表明,许多儿童,特别是肥胖儿童或有其他潜在医疗条件的儿童,在腺样体扁桃体切除术(儿童阻塞性睡眠呼吸暂停的主要治疗方法)后仍存在残留的阻塞性睡眠呼吸暂停。这些儿童可以通过持续气道正压通气进行有效治疗,但治疗的依从性差是一个显著的局限性。因此,需要为小儿阻塞性睡眠呼吸暂停综合征提供新的治疗方法。目前的研究集中在治疗小儿阻塞性睡眠呼吸暂停的新方法上,如抗炎药、牙齿治疗、高流量鼻导管和减肥。然而,评估这些疗法有效性的随机对照试验很少。需要进一步的研究。