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肥胖儿童睡眠呼吸障碍对生活质量的长期影响。

Long-Term Impact of Sleep-Disordered Breathing on Quality of Life in Children With Obesity.

机构信息

Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.

Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.

出版信息

J Clin Sleep Med. 2018 Mar 15;14(3):451-458. doi: 10.5664/jcsm.6998.

Abstract

STUDY OBJECTIVES

(1) To determine baseline quality of life (QOL) among children with obesity and newly diagnosed moderate-severe sleep-disordered breathing (SDB) and to compare it to the reported QOL of children with obesity or SDB alone and healthy children. (2) To evaluate QOL change after 1 year.

METHODS

A prospective multicenter cohort study was conducted in children (8-16 years) with obesity, prescribed positive airway pressure (PAP) therapy for moderate-severe SDB. Outcomes included parent-proxy and self-report total and subscale scores on the PedsQL questionnaire (baseline and 1-year).

RESULTS

Total PedsQL scores were indicative of impaired QOL in 69% of cases based on parent-report and in 62% on self-report. Parents reported significantly lower QOL in our cohort than that reported in other studies for children with obesity or SDB alone or healthy children, on total PedsQL score and on social and psychosocial subscales. PedsQL total scores for participants were significantly higher (mean difference 7.3 ± 15.3, = .03) than those reported by parents. Parents reported significant improvements in total PedsQL (mean change 7.29 ± 13.73, = .04) and social functioning (mean change 17.65 ± 24.69, = .04) scores after 1 year. No significant differences were found by children's self-report or by PAP adherence.

CONCLUSIONS

QOL of children with obesity and SDB is lower than in children with obesity or SDB alone or healthy children. One year later, children reported no significant changes in QOL; parents reported significant improvements in total PedsQL and social functioning scores. PAP adherence did not significantly affect QOL change in this population.

COMMENTARY

A commentary on this article appears in this issue on page 307.

摘要

研究目的

(1)确定肥胖且新诊断为中重度睡眠呼吸障碍(SDB)儿童的基线生活质量(QOL),并将其与肥胖或 SDB 儿童或健康儿童的报道 QOL 进行比较。(2)评估 1 年后 QOL 的变化。

方法

一项前瞻性多中心队列研究在患有肥胖症且被处方中重度 SDB 正压通气(PAP)治疗的儿童(8-16 岁)中进行。结果包括家长和儿童分别报告的 PedsQL 问卷的总得分和子量表得分(基线和 1 年)。

结果

根据家长报告,69%的病例和根据自我报告,62%的病例的 PedsQL 总得分表明 QOL 受损。与其他研究报道的肥胖或 SDB 儿童或健康儿童相比,家长报告我们队列中的儿童的 QOL 明显更低,PedsQL 总分和社会心理子量表得分均更低。参与者的 PedsQL 总分明显更高(平均差异 7.3 ± 15.3, =.03),而不是家长报告的分数。家长报告 1 年后 PedsQL 总分(平均变化 7.29 ± 13.73, =.04)和社会功能(平均变化 17.65 ± 24.69, =.04)显著改善。但儿童自我报告或 PAP 依从性没有发现显著差异。

结论

肥胖和 SDB 儿童的 QOL 低于肥胖或 SDB 儿童或健康儿童。1 年后,儿童报告 QOL 没有显著变化;家长报告 PedsQL 总分和社会功能得分显著改善。在该人群中,PAP 依从性对 QOL 变化没有显著影响。

评论

本文的一篇评论文章见本期第 307 页。

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