Austeng Marit Erna, Øverland Britt, Kværner Kari Jorunn, Andersson Els-Marie, Axelsson Stefan, Abdelnoor Michael, Akre Harriet
Østfold Hospital Trust, Department of Otorhinolaryngology, Head and Neck Surgery, Norway; Department of Health Economics and Health Management, University of Oslo, Norway.
Sleep Unit, Department of Otorhinolaryngology/Head and Neck Surgery, Lovisenberg Diakonale Hospital, Norway.
Int J Pediatr Otorhinolaryngol. 2014 Jul;78(7):1026-9. doi: 10.1016/j.ijporl.2014.03.030. Epub 2014 Apr 8.
We aimed to assess the prevalence of obstructive sleep apnea (OSA) in 8 year old school children with Down syndrome (DS). While the prevalence in otherwise healthy children is below 5%, the prevalence estimates in children with DS are uncertain (30-80%). OSA directly affects cognitive development and school performance.
Population based cross sectional study in a limited geographical area.
Polysomnography (PSG) with video and audio recordings was performed in 8-year-old children with DS in a pediatric sleep unit according to the guidelines of American Academy of Sleep Medicine. Twenty-nine of all 32 children with DS within a restricted area comprising >50% of the Norwegian population and 54% of the children with DS born in Norway in 2002 were enrolled.
This study reports an apnea hypopnea index AHI>1.5 in 28 of 29 children and an obstructive apnea index (OAI)>1 in 24 of 29 children. 19 children (66%) had an AHI>5 and 17 children (59%) had an OAI>5 which indicated moderate to severe OSA. No correlation was found between OSA and obesity or gender.
The high prevalence of disease found in these previously undiagnosed 8-year-old children underlines the importance of performing OSA diagnostics in children with DS throughout childhood. These findings suggest that the prevalence of OSA remains high up to early school years. In contrast to earlier publications, this current study has the advantage of being population based, the study is performed on children of a narrow age band to estimate prevalence of disease and the diagnostic gold standard of PSG is applied.
我们旨在评估8岁唐氏综合征（DS）学龄儿童阻塞性睡眠呼吸暂停（OSA）的患病率。虽然健康儿童的患病率低于5%，但DS患儿的患病率估计尚不确定（30%-80%）。OSA直接影响认知发育和学业表现。
在有限地理区域内进行基于人群的横断面研究。
根据美国睡眠医学学会的指南，在儿科睡眠单元对8岁的DS患儿进行了带有视频和音频记录的多导睡眠图（PSG）检查。在一个占挪威人口50%以上且包含2002年在挪威出生的54%的DS患儿的受限区域内，32名DS患儿中的29名被纳入研究。
本研究报告29名儿童中有28名呼吸暂停低通气指数（AHI）>1.5，29名儿童中有24名阻塞性呼吸暂停指数（OAI）>1。19名儿童（66%）的AHI>5，17名儿童（59%）的OAI>5，这表明为中度至重度OSA。未发现OSA与肥胖或性别之间存在相关性。
在这些之前未被诊断的8岁儿童中发现的高患病率凸显了在DS患儿整个童年期进行OSA诊断的重要性。这些发现表明，直至学龄早期OSA的患病率仍然很高。与早期出版物不同，本研究具有基于人群的优势，该研究针对年龄范围较窄的儿童进行以估计疾病患病率，并且应用了PSG的诊断金标准。
