自闭症谱系障碍儿童中已诊断睡眠障碍及相关诊断和外科手术的患病率。

Prevalence of Diagnosed Sleep Disorders and Related Diagnostic and Surgical Procedures in Children with Autism Spectrum Disorders.

作者信息

Elrod Marilisa G, Nylund Cade M, Susi Apryl L, Gorman Gregory H, Hisle-Gorman Elizabeth, Rogers Derek J, Erdie-Lalena Christine

机构信息

*Developmental-Behavioral Pediatrics Department, Madigan Army Medical Center, Joint Base Lewis McChord, WA; †Pediatric Department, Uniformed Services University, Bethesda, MD; ‡Pediatric Otolaryngology Department, Madigan Army Medical Center, Joint Base Lewis McChord, WA; §Pediatric Department, Pediatric Subspecialty Services, Walter Reed National Military Medical Center, Bethesda, MD.

出版信息

J Dev Behav Pediatr. 2016 Jun;37(5):377-84. doi: 10.1097/DBP.0000000000000248.

DOI:10.1097/DBP.0000000000000248

PMID:26982246

Abstract

OBJECTIVE

Sleep disorders are common and important comorbid conditions in children with autism spectrum disorder (ASD) and can contribute to cognitive and behavioral problems. Sleep-disordered breathing (SDB) is a diagnosable and treatable cause of behavioral problems in children. We aimed to quantify the relative risk for children with ASD versus controls of being diagnosed with sleep disorders including SDB and undergoing related diagnostic and surgical procedures.

METHOD

This retrospective case-cohort study included 48,762 children with ASD aged 2 to 18 years enrolled in the military health system (MHS) from 2000 to 2013. Children with ASD were matched 1:5 by birthdate, sex, and enrollment time to children without an ASD diagnosis. The MHS database was queried for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for sleep disorders or ICD-9-CM and Current Procedural Terminology codes for diagnostic and surgical procedures. Relative risks (RR) and 95% confidence intervals (CI) were determined with binary Poisson regression conditional on the match and adjusting for confounders.

RESULTS

Children with ASD were at higher risk of receiving any sleep disorder diagnosis (RR: 1.97 [95% CI, 1.91-2.02]) including SDB (RR: 1.96 [95% CI, 1.88-2.05]). Children with ASD also were at increased risk of undergoing polysomnography (RR: 3.74 [95% CI, 3.56-3.93]) and sleep disorder-related surgery (RR: 1.50 [95% CI, 1.46-1.54]).

CONCLUSION

Children with ASD are more likely to be given a sleep disorder diagnosis including SDB and are more likely to undergo related diagnostic and surgical procedures compared with controls without ASD.

摘要

目的

睡眠障碍在自闭症谱系障碍（ASD）儿童中是常见且重要的共病情况，可导致认知和行为问题。睡眠呼吸紊乱（SDB）是儿童行为问题的一种可诊断和可治疗的病因。我们旨在量化ASD儿童与对照组相比被诊断为包括SDB在内的睡眠障碍以及接受相关诊断和外科手术的相对风险。

方法

这项回顾性病例队列研究纳入了2000年至2013年在军事医疗系统（MHS）登记的48762名2至18岁的ASD儿童。ASD儿童按出生日期、性别和登记时间与未诊断为ASD的儿童以1:5的比例进行匹配。查询MHS数据库以获取国际疾病分类第九版临床修订本（ICD-9-CM）中睡眠障碍的编码或ICD-9-CM以及当前程序术语中诊断和外科手术的编码。通过基于匹配条件的二元泊松回归并调整混杂因素来确定相对风险（RR）和95%置信区间（CI）。

结果

ASD儿童接受任何睡眠障碍诊断的风险更高（RR：1.97 [95% CI，1.91 - 2.02]），包括SDB（RR：1.96 [95% CI，1.88 - 2.05]）。ASD儿童接受多导睡眠图检查的风险也增加（RR：3.74 [95% CI，3.56 - 3.93]）以及与睡眠障碍相关手术的风险增加（RR：1.50 [95% CI，1.46 - 1.54]）。