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唐氏综合征患儿的睡眠呼吸障碍:家庭多导睡眠图的效用

Sleep-disordered breathing in children with Down syndrome: Usefulness of home polysomnography.

作者信息

Brockmann Pablo E, Damiani Felipe, Nuñez Felipe, Moya Ana, Pincheira Eduardo, Paul Maria A, Lizama Macarena

机构信息

Department of Pediatric Cardiology and Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Sleep Medicine Center, Department of Neurology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Int J Pediatr Otorhinolaryngol. 2016 Apr;83:47-50. doi: 10.1016/j.ijporl.2016.01.030. Epub 2016 Feb 1.

Abstract

OBJECTIVE

To investigate the technical feasibility of unattended home polysomnography (HPSG) in children with Down syndrome.

METHODS

Data from children with Down syndrome under 10 years of age referred to a diagnostic sleep study was analyzed. A full sleep-lab based polysomnography (PSG) or a HPSG with a portable device was performed. Uninterpretable HPSGs were defined as: recordings with (i) loss of ≥2 of the following channels: nasal flow, or thoracoabdominal sensors, or (ii) HPSG with less than 4h of artifact-free recording time or (iii) less than 4h SpO2 (peripheral capillary oxygen saturation) signal.

RESULTS

A total of 44 children (68% males) were included in the study, with a mean age of 3.6 (0.1-10) years. PSG was performed in 8 cases and HPSG in 36 cases. Six HPSG recordings were classified as uninterpretable and had to be repeated. Age, gender and BMI were no significant predictors of uninterpretability of the HPSG. Obstructive sleep apnea (OSA) was present in 61% (n=27) of all subjects, and classified as mild, moderate, and severe in 43% (n=19), 11% (n=5), and 7% (n=3) of cases, respectively. Interpretable and technically acceptable HPSGs were obtained in 30 subjects (83%). Age, gender and BMI were no significant predictors for interpretability of the HPSG.

DISCUSSION

This study demonstrates that a portable polysomnographic home device may be helpful for diagnosing OSA in children with Down syndrome. Considering the potential consequences of untreated OSA, this screening test may be helpful for early diagnosis of OSA in children with Down syndrome.

摘要

目的

探讨无人值守家庭多导睡眠图(HPSG)在唐氏综合征患儿中的技术可行性。

方法

分析10岁以下唐氏综合征患儿诊断性睡眠研究的数据。进行了基于全睡眠实验室的多导睡眠图(PSG)或使用便携式设备的HPSG。无法解读的HPSG定义为:(i)以下通道中至少2个通道信号丢失:鼻气流、胸腹部传感器;或(ii)HPSG无伪迹记录时间少于4小时;或(iii)SpO2(外周毛细血管血氧饱和度)信号少于4小时。

结果

本研究共纳入44例患儿(68%为男性),平均年龄3.6(0.1 - 10)岁。8例进行了PSG,36例进行了HPSG。6份HPSG记录被分类为无法解读,必须重新进行。年龄、性别和BMI不是HPSG无法解读的显著预测因素。所有受试者中61%(n = 27)存在阻塞性睡眠呼吸暂停(OSA),分别有43%(n = 19)、11%(n = 5)和7%(n = 3)的病例被分类为轻度、中度和重度OSA。30名受试者(83%)获得了可解读且技术上可接受的HPSG。年龄、性别和BMI不是HPSG可解读性的显著预测因素。

讨论

本研究表明,便携式多导睡眠图家庭设备可能有助于诊断唐氏综合征患儿的OSA。考虑到未经治疗的OSA的潜在后果,这种筛查测试可能有助于唐氏综合征患儿OSA的早期诊断。

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