Section of Respiratory Disease, Department of Clinical Medicine and Surgery, Monaldi Hospital, University "Federico II" Naples, Via Leonardo Bianchi, 80131, Naples, Italy.
Departments of Translational and Medical Sciences, University "Federico II" Naples, Naples, Italy.
Eur J Pediatr. 2018 Sep;177(9):1367-1370. doi: 10.1007/s00431-017-3083-9. Epub 2018 Jan 9.
Sleep-related disordered breathing (SDB) is very common in paediatric patients affected by Prader-Willi Syndrome (PWS). However, data addressing SBD patterns and their management are lacking. The aim of the present study was to analyse SDB features in 14 PWS patients (age range, 8 months-17 years). Polygraphic registration (PG) during a 12-h nocturnal sleep was performed in all patients. Obstructive and central apnoea indices and oxygen saturation (SpO) were recorded along with demographic and clinical data. Obstructive sleep apnoea (OSA) was diagnosed in 13/14 patients (92.9%); the mean obstructive apnoea-hypopnea index (OAHI) was 7.6 ± 4.2 events/h with a mean central apnoea index (CAI) of 0.7 ± 1.04 events/h. Time spent with SpO < 90% was of 0.02% [range 0-23%], with a mean oxygen desaturation index of 12.1 ± 6.9 events/h. No correlation was found between OAHI and body mass index (mean BMI 28 ± 9.8 kg/m and BMI z-score 2.7 ± 1.7).
OSA was the predominant sleep-related disorder in our PWS patients, not associated with age or obesity, and appeared more severe than previously reported. Further studies addressing the underlying mechanisms are necessary in larger study populations to better design the most appropriate clinical approach. What is Known: • Sleep-related patterns and their management are very limited in patients with Prader-Willi syndrome. What is New: • Severe obstructive sleep apnoea is the most frequent sleep-related disorder in our case series.
睡眠相关的呼吸障碍(SDB)在患有普拉德-威利综合征(PWS)的儿科患者中非常常见。然而,缺乏有关 SBD 模式及其管理的数据。本研究的目的是分析 14 例 PWS 患者(年龄 8 个月至 17 岁)的 SDB 特征。所有患者均进行了 12 小时夜间睡眠的多导睡眠图记录。记录阻塞性和中枢性呼吸暂停指数以及氧饱和度(SpO2),并记录人口统计学和临床数据。14 例患者中有 13 例(92.9%)诊断为阻塞性睡眠呼吸暂停(OSA);阻塞性呼吸暂停低通气指数(OAHI)的平均值为 7.6±4.2 次/小时,中枢性呼吸暂停指数(CAI)的平均值为 0.7±1.04 次/小时。SpO2<90%的时间为 0.02%[0-23%],平均氧减指数为 12.1±6.9 次/小时。OAHI 与体重指数(平均 BMI 28±9.8kg/m 和 BMI z 分数 2.7±1.7)之间无相关性。
OSA 是我们 PWS 患者中最主要的睡眠相关障碍,与年龄或肥胖无关,且比以前报道的更为严重。需要在更大的研究人群中进行进一步的研究,以探讨潜在的发病机制,从而更好地设计最合适的临床方法。已知:• 普拉德-威利综合征患者的睡眠模式及其管理非常有限。新发现:• 严重的阻塞性睡眠呼吸暂停是我们的病例系列中最常见的睡眠相关障碍。