Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
University of Toronto, Toronto, ON, Canada.
Sleep Breath. 2018 May;22(2):511-515. doi: 10.1007/s11325-017-1576-4. Epub 2017 Oct 13.
Obstructive sleep apnea (OSA) is a common disorder estimated at 1-5% in the school-aged children. With the obesity prevalence reaching staggering rates globally, OSA in obese adolescents is estimated to be 4-5-folds higher than their lean peers. There is a paucity of data regarding obesity-related OSA in children 6 years and less. This is particularly relevant as OSA is associated with neurocognitive deficits. The aim of this study is to evaluate the prevalence of OSA among obese toddlers and preschool children and further to determine what other factors may be associated with the presence of OSA.
A retrospective study involving children ≤6 years, identified from two Canadian pediatric tertiary care centers who had an in-lab polysomnography (PSG). Obesity was defined by a BMI of > 95th percentile for age and gender or a z-score of > 2. OSA was diagnosed if the obstructive apnea-hypopnea index (OAHI) was greater than 2 events per hour.
There were 60 participants included; the mean age was 4.4 years (standard deviation [SD] ± 1.7), mean BMI z-score was 3.0 (SD ± 1.2). Of these, 22/60 (36.6%) had OSA. Compared with the non-OSA group, the OSA group had a higher Epworth sleepiness score (p = 0.03) and were more likely to snore (p = 0.01).
Young obese children should be assessed for OSA. A history of snoring and daytime sleepiness may be useful indicators to facilitate triage for a PSG, especially in resource-limited settings.
阻塞性睡眠呼吸暂停（OSA）是一种常见疾病，估计在学龄儿童中占 1-5%。随着肥胖症在全球范围内的患病率达到惊人的水平，肥胖青少年的 OSA 估计比他们的瘦同龄人高 4-5 倍。关于 6 岁及以下儿童肥胖相关 OSA 的数据很少。这一点尤其重要，因为 OSA 与神经认知缺陷有关。本研究的目的是评估肥胖学步儿童和学龄前儿童 OSA 的患病率，并进一步确定可能与 OSA 存在相关的其他因素。
这是一项回顾性研究，涉及在加拿大两家儿科三级保健中心进行实验室多导睡眠图（PSG）检查的 ≤6 岁儿童。肥胖的定义为 BMI 大于年龄和性别的第 95 百分位或 z 评分大于 2。如果阻塞性呼吸暂停-低通气指数（OAHI）大于 2 次/小时，则诊断为 OSA。
共有 60 名参与者入选，平均年龄为 4.4 岁（标准差 ±1.7），平均 BMI z 评分 3.0（标准差 ±1.2）。其中 22/60（36.6%）患有 OSA。与非 OSA 组相比，OSA 组的 Epworth 嗜睡评分更高（p=0.03），且更有可能打鼾（p=0.01）。
应评估肥胖的年轻儿童是否患有 OSA。打鼾和白天嗜睡的病史可能是有助于 PSG 分诊的有用指标，尤其是在资源有限的情况下。
