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儿童日间过度嗜睡的临床和多导睡眠图特征

Clinical and polysomnographic characteristics of excessive daytime sleepiness in children.

作者信息

Lee Jiwon, Na Geonyoub, Joo Eun Yeon, Lee Munhyang, Lee Jeehun

机构信息

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.

出版信息

Sleep Breath. 2017 Dec;21(4):967-974. doi: 10.1007/s11325-017-1545-y. Epub 2017 Aug 18.

Abstract

PURPOSE

This study aimed to delineate the clinical and polysomnography (PSG) characteristics of sleep disorders in children with excessive daytime sleepiness (EDS).

METHODS

Between February 2002 and June 2015, 622 pediatric patients with EDS were evaluated with overnight PSG and the Multiple Sleep Latency Test at the Samsung Medical Center. The medical records; questionnaire responses about depression, sleepiness, sleep habits; and sleep study data of 133 patients without obstructive sleep apnea (OSA) were reviewed retrospectively.

RESULTS

The patients (63 girls, 70 boys) slept for an average of 7 h 30 min and 8 h 44 min on weekdays and weekends, respectively. The mean Epworth Sleepiness Scale score was 11.01 ± 4.09 and did not differ significantly among sleep disorders. Among the 102 patients who completed the depression questionnaire, 53 showed depressive feelings, which were moderate or severe in 39, with no significant differences among specific sleep disorders. Thirty-four patients exhibited normal PSG results. Seventeen of them were concluded as not having any sleep disorders, and the others as having delayed sleep phase disorder (DSPD). Narcolepsy (n = 78) was the most common disorder, followed by DSPD (n = 17) and idiopathic hypersomnia (n = 12).

CONCLUSIONS

Pediatric patients with EDS had various sleep disorders and some did not have any sleep disorder despite EDS. More than half the patients with EDS showed depressive feelings affecting their daily lives. For pediatric patients with EDS, a systematic diagnostic approach including questionnaires for sleep habits and emotion and PSG is essential for accurate diagnosis and treatment.

摘要

目的

本研究旨在描述日间过度嗜睡(EDS)儿童睡眠障碍的临床及多导睡眠图(PSG)特征。

方法

2002年2月至2015年6月期间,622例患有EDS的儿科患者在三星医疗中心接受了夜间PSG检查和多次睡眠潜伏期测试。回顾性分析了133例无阻塞性睡眠呼吸暂停(OSA)患者的病历、关于抑郁、嗜睡、睡眠习惯的问卷调查回复以及睡眠研究数据。

结果

这些患者(63名女孩,70名男孩)平日平均睡眠时间为7小时30分钟,周末平均睡眠时间为8小时44分钟。Epworth嗜睡量表平均得分为11.01±4.09,在不同睡眠障碍之间无显著差异。在102例完成抑郁问卷的患者中,53例有抑郁情绪,其中39例为中度或重度,在特定睡眠障碍之间无显著差异。34例患者PSG结果正常。其中17例被判定没有任何睡眠障碍,其他患者被判定患有睡眠相位延迟障碍(DSPD)。发作性睡病(n = 78)是最常见的疾病,其次是DSPD(n = 17)和特发性嗜睡症(n = 12)。

结论

患有EDS的儿科患者存在多种睡眠障碍,部分患者尽管有EDS但没有任何睡眠障碍。超过一半的EDS患者有影响其日常生活的抑郁情绪。对于患有EDS的儿科患者,包括睡眠习惯和情绪问卷以及PSG的系统诊断方法对于准确诊断和治疗至关重要。

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