Khassawneh Basheer, Tsai Sheila C, Meltzer Lisa J
Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Medicine, National Jewish Health, Denver, CO, USA.
Sleep Breath. 2019 Sep;23(3):943-951. doi: 10.1007/s11325-018-01774-3. Epub 2019 Jan 28.
The aim of this study was to describe the polysomnographic characteristics of adolescents with asthma who are at low risk for sleep-disordered breathing (SDB) based on the Pediatric Sleep Questionnaire (PSQ).
Overnight polysomnography was performed on 85 adolescents with asthma and a score < 0.33 on the PSQ. The Asthma Control Questionnaire was used to define "well-controlled" versus "inadequately controlled" asthma.
Mean age of participants was 14.5 ± 1.6 years (range, 11 to 17 years), 63.5% were girls, 57.6% were Caucasians, and the mean body mass index percentile was 65.1 ± 26.5. Asthma was well-controlled in 51.7% of the adolescents and inadequately controlled in 15.3%. Mean sleep efficiency (SE) was 88.0 ± 11.1%, and 24.7% had SE < 85%. Mean wakefulness after sleep onset (WASO) was 40.9 ± 44.0 min, and the mean arousal index was 10.8 ± 5.6 per hour. The mean apnea/hypopnea index (AHI) was 2.3 ± 4.2, and 29.4% of participants had SDB (defined by an AHI ≥ 2). Compared with normative values, adolescents with asthma had more nocturnal awakenings and WASO, and less REM sleep. SDB risk was higher in boys [odds ratio = 4.6 (confidence interval 1.4-14.7), p = 0.01]. Asthma control did not impact sleep and respiratory parameters, with no differences found between youth with well-controlled and inadequately controlled asthma.
Adolescents with asthma are at increased risk of sleep-disordered breathing and suffer from disturbances in sleep continuity with more arousals and sleep fragmentation. Study results highlight the importance of proper screening for sleep-disordered breathing in adolescents with asthma.
本研究旨在描述基于儿童睡眠问卷（PSQ），睡眠呼吸障碍（SDB）低风险的哮喘青少年的多导睡眠图特征。
对85名哮喘青少年进行夜间多导睡眠图检查，其PSQ评分<0.33。使用哮喘控制问卷来定义“控制良好”与“控制不佳”的哮喘。
参与者的平均年龄为14.5±1.6岁（范围11至17岁），63.5%为女孩，57.6%为白种人，平均体重指数百分位数为65.1±26.5。51.7%的青少年哮喘控制良好，15.3%控制不佳。平均睡眠效率（SE）为88.0±11.1%，24.7%的人SE<85%。睡眠开始后的平均觉醒时间（WASO）为40.9±44.0分钟，平均觉醒指数为每小时10.8±5.6次。平均呼吸暂停/低通气指数（AHI）为2.3±4.2，29.4%的参与者患有SDB（定义为AHI≥2）。与正常值相比，哮喘青少年夜间觉醒和WASO更多，快速眼动睡眠更少。男孩的SDB风险更高[优势比=4.6（置信区间1.4 - 14.7），p = 0.01]。哮喘控制情况不影响睡眠和呼吸参数，控制良好和控制不佳的青少年之间未发现差异。
哮喘青少年睡眠呼吸障碍风险增加，睡眠连续性受到干扰，觉醒更多且睡眠碎片化。研究结果强调了对哮喘青少年进行睡眠呼吸障碍适当筛查的重要性。
