Stollery Children's Hospital, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
Stollery Children's Hospital, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
Sleep Med. 2018 Jul;47:44-50. doi: 10.1016/j.sleep.2018.03.006. Epub 2018 Mar 29.
To determine the scope of sleep concerns, clinical features, and polysomnography (PSG) results and to identify factors that predict obstructive sleep apnea (OSA) in a cohort of children with obesity.
The study was a multicenter retrospective chart review. Data were collected from three pediatric sleep laboratories over a two year period for all children of age 8-16 years with a body mass index [BMI] ≥95th centile who were undergoing PSG. Data sources included clinical charts and PSG results. Clinical and PSG factors were examined as predictors of OSA.
A total of 210 children met inclusion criteria, and 205 had sufficient data for analysis. The mean age was 12.5 ± 2.7 years; and 65% were male. Multiple sleep concerns and comorbidities were reported in most children (90% and 91%, respectively). OSA was identified by PSG in 44% of children; and 28% of children demonstrated moderate/severe OSA. Mouth breathing/nasal congestion (odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.18-0.61), syndrome/multiple anomalies (OR = 2.4, 95% CI = 1.22-4.93), and family history of OSA (OR = 2.7, 95% CI = 1.2-5.8) or sleep problems (OR = 12.4, 95% CI = 1.5, 99.6) were the only factors predictive of OSA. Oxygen desaturation index <6 events/h measured by PSG showed an OR of 4.96 (95% CI = 2.27-10.86) for the absence of OSA.
Children with obesity who undergo PSG are medically complex with multiple sleep concerns including a high burden of daytime symptoms; slightly less than half of children demonstrate polysomnographic features of OSA. Earlier identification of OSA, recognition of non-OSA sleep concerns, and treatment strategies to improve sleep may contribute to overall health outcomes for children with obesity.
确定肥胖儿童群体中睡眠问题的范围、临床特征和多导睡眠图（PSG）结果，并确定预测阻塞性睡眠呼吸暂停（OSA）的因素。
这是一项多中心回顾性图表审查研究。在两年期间，从三个儿科睡眠实验室收集所有年龄在 8-16 岁、体重指数（BMI）≥第 95 百分位数并接受 PSG 检查的肥胖儿童的临床图表和 PSG 数据。临床和 PSG 因素被视为 OSA 的预测因素。
共有 210 名儿童符合纳入标准，其中 205 名儿童有足够的数据进行分析。平均年龄为 12.5±2.7 岁，65%为男性。大多数儿童报告存在多种睡眠问题和合并症（分别为 90%和 91%）。PSG 确定 44%的儿童存在 OSA，28%的儿童存在中重度 OSA。口呼吸/鼻塞（比值比[OR]为 0.33，95%置信区间[CI]为 0.18-0.61）、综合征/多种异常（OR 为 2.4，95%CI 为 1.22-4.93）以及 OSA 家族史（OR 为 2.7，95%CI 为 1.2-5.8）或睡眠问题（OR 为 12.4，95%CI 为 1.5-99.6）是唯一预测 OSA 的因素。PSG 测量的氧减饱和度指数<6 事件/小时提示无 OSA 的 OR 为 4.96（95%CI 为 2.27-10.86）。
接受 PSG 检查的肥胖儿童存在多种睡眠问题，包括白天症状负担重，属于高度复杂的医疗群体；仅有不到一半的儿童表现出 OSA 的多导睡眠图特征。早期识别 OSA、认识到非 OSA 睡眠问题以及改善睡眠的治疗策略可能有助于肥胖儿童的整体健康结果。
