青少年特发性关节炎中的睡眠障碍与神经行为表现
Sleep Disturbances and Neurobehavioral Performance in Juvenile Idiopathic Arthritis.
作者信息
Ward Teresa M, Beebe Dean W, Chen Maida Lynn, Landis Carol A, Ringold Sarah, Pike Ken, Wallace Carol A
机构信息
From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
出版信息
J Rheumatol. 2017 Mar;44(3):361-367. doi: 10.3899/jrheum.160556. Epub 2017 Jan 15.
OBJECTIVE
To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea hypopnea index (OAHI), number of wake bouts, arousals, periodic limb movements] and the effect of OAHI on neurobehavioral performance in juvenile idiopathic arthritis (JIA) with obstructive sleep apnea (OSA), JIA without OSA, and controls without OSA, adjusting for intelligence quotient (IQ), pain, medications, daytime sleepiness, and wake bouts.
METHODS
Children 6-11 years, 68 with JIA and 67 controls, underwent 1 night of PSG and completed self-reported daytime sleepiness surveys, multiple sleep latency tests for physiological sleepiness, and neurobehavioral performance tests the next day.
RESULTS
Compared with JIA and controls without OSA, mean OAHI and arousals were significantly higher in JIA with OSA (p < 0.001, respectively). In comparison with JIA and controls without OSA, mean simple reaction time and sustained attention were significantly slower in JIA with OSA, adjusting for IQ, pain, any medication, daytime sleepiness, and wake bouts.
CONCLUSION
Elevated OAHI is suggestive of obstructive sleep apnea and a comorbidity in JIA that may predispose children with JIA to daytime sleepiness and impaired neurobehavioral performance.
目的
研究多导睡眠图（PSG）睡眠障碍的程度[阻塞性呼吸暂停低通气指数（OAHI）、觉醒次数、觉醒、周期性肢体运动]，以及OAHI对患有阻塞性睡眠呼吸暂停（OSA）的幼年特发性关节炎（JIA）、不伴有OSA的JIA和不伴有OSA的对照组儿童神经行为表现的影响，并对智商（IQ）、疼痛、药物治疗、日间嗜睡和觉醒次数进行校正。
方法
68例6至11岁的JIA患儿和67例对照组儿童接受了1晚的PSG监测，并完成了自我报告的日间嗜睡调查、用于评估生理性嗜睡的多次睡眠潜伏期测试，以及次日的神经行为表现测试。
结果
与不伴有OSA的JIA患儿和对照组相比，伴有OSA的JIA患儿的平均OAHI和觉醒次数显著更高（p均<0.001）。在校正IQ、疼痛、任何药物治疗、日间嗜睡和觉醒次数后，与不伴有OSA的JIA患儿和对照组相比，伴有OSA的JIA患儿的平均简单反应时间和持续注意力显著更慢。
结论
升高的OAHI提示阻塞性睡眠呼吸暂停以及JIA中的一种共病，这可能使JIA患儿易出现日间嗜睡和神经行为表现受损。
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