Fan Zheng, Ahn Mihye, Roth Heidi L, Li Leping, Vaughn Bradley V
Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Department of Mathematics and Statistics, University of Nevada, Reno, NV 89503, USA.
Children (Basel). 2017 Jun 30;4(7):55. doi: 10.3390/children4070055.
Patients with Down syndrome (DS) are at risk for both obstructive sleep apnea (OSA) and central sleep apnea (CSA); however, it is unclear how these components evolve as patients age and whether patients are also at risk for hypoventilation. A retrospective review of 144 diagnostic polysomnograms (PSG) in a tertiary care facility over 10 years was conducted. Descriptive data and exploratory correlation analyses were performed. Sleep disordered breathing was common (seen in 78% of patients) with an average apnea-hypopnea index (AHI) = 10. The relative amount of obstructive apnea was positively correlated with age and body mass index (BMI). The relative amount of central sleep apnea was associated with younger age in the very youngest group (0-3 years). Hypoventilation was common occurring in more than 22% of patients and there was a positive correlation between the maximum CO₂ and BMI. Sleep disordered breathing, including hypoventilation, was common in patients with DS. The obstructive component increased significantly with age and BMI, while the central component occurred most in the very young age group. Due to the high risk of hypoventilation, which has not been previously highlighted, it may be helpful to consider therapies to target both apnea and hypoventilation in this population.
唐氏综合征（DS）患者存在阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停（CSA）的风险；然而，目前尚不清楚随着患者年龄增长这些情况如何演变，以及患者是否也有通气不足的风险。我们对一家三级医疗机构10年间的144份诊断性多导睡眠图（PSG）进行了回顾性研究。进行了描述性数据和探索性相关分析。睡眠呼吸障碍很常见（78%的患者出现），平均呼吸暂停低通气指数（AHI）=10。阻塞性呼吸暂停的相对比例与年龄和体重指数（BMI）呈正相关。中枢性睡眠呼吸暂停的相对比例在最年幼的组（0 - 3岁）与较年轻的年龄相关。通气不足很常见，超过22%的患者出现，并且最大二氧化碳值与BMI之间存在正相关。睡眠呼吸障碍，包括通气不足，在DS患者中很常见。阻塞性成分随年龄和BMI显著增加，而中枢性成分在非常年幼的年龄组中最为常见。由于通气不足的高风险此前未被强调，考虑针对该人群的呼吸暂停和通气不足的治疗方法可能会有所帮助。
