Tamanyan Knarik, Walter Lisa M, Davey Margot J, Nixon Gillian M, Horne Rosemary Sc, Biggs Sarah N
The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2016 May;52(5):512-7. doi: 10.1111/jpc.13120.
This study aims to determine whether demographic or clinical factors predict obstructive sleep apnoea (OSA) severity in Australian children.
Demographic details and medical histories of 301 Australian children (3-17 years old) referred for assessment of OSA were examined retrospectively. Children underwent overnight polysomnography and were classified as having primary snoring (PS) (obstructive apnoea hypopnoea index (OAHI) ≤ 1 event per hour; n = 150), mild OSA (>1 OAHI ≤ 5 events per hour; n = 76) or moderate/severe (MS) OSA (OAHI > 5 events per hour; n = 75). Information obtained from parent-report questionnaire determined the predictive value of the following factors for determining OSA severity: gender, ethnicity, body mass index, asthma and/or allergic rhinitis, socio-economic status and parental smoking status (mother/father/both). Chi-squared analyses were used to compare the distribution of the demographic and clinical factors across the three groups. Statistically significant risk factors were subsequently entered into logistic regression analysis.
Ethnicity and parental smoking were significant risk factors for MS OSA. Children with non-Caucasian ethnicity were 36% more likely than Caucasian children to be diagnosed with MS OSA than PS (P = 0.002). Children with fathers who smoked were 53% more likely to have MS OSA than PS compared with those with fathers who did not smoke (P = 0.008). Obesity was associated with OSA severity in primary school-aged children only. Gender, socio-economic status and history of asthma and/or allergic rhinitis were not risk factors.
Non-Caucasian ethnicity, paternal smoking and obesity in older children were associated with an increased risk of polysomnography-confirmed MS OSA in Australian children.
本研究旨在确定人口统计学或临床因素是否可预测澳大利亚儿童阻塞性睡眠呼吸暂停（OSA）的严重程度。
回顾性研究了301名因OSA评估而转诊的澳大利亚儿童（3至17岁）的人口统计学细节和病史。儿童接受了整夜多导睡眠图监测，并被分类为患有原发性打鼾（PS）（阻塞性呼吸暂停低通气指数（OAHI）≤每小时1次事件；n = 150）、轻度OSA（>1次OAHI≤每小时5次事件；n = 76）或中度/重度（MS）OSA（OAHI>每小时5次事件；n = 75）。从家长报告问卷中获得的信息确定了以下因素对确定OSA严重程度的预测价值：性别、种族、体重指数、哮喘和/或过敏性鼻炎、社会经济地位以及父母吸烟状况（母亲/父亲/双方）。采用卡方分析比较三组人群中人口统计学和临床因素的分布情况。随后将具有统计学意义的危险因素纳入逻辑回归分析。
种族和父母吸烟是MS OSA的重要危险因素。非白种人儿童被诊断为MS OSA而非PS的可能性比白种人儿童高36%（P = 0.002）。与父亲不吸烟的儿童相比，父亲吸烟的儿童患MS OSA而非PS的可能性高53%（P = 0.008）。肥胖仅与小学年龄段儿童的OSA严重程度相关。性别、社会经济地位以及哮喘和/或过敏性鼻炎病史不是危险因素。
在澳大利亚儿童中，非白种人种族、父亲吸烟以及大龄儿童肥胖与多导睡眠图确诊的MS OSA风险增加有关。
